Palladino, Geraldine S 4
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section it'"a ''� • Burial - Transit Permit
Name First Middle Last ' Sex
Geraldine Palladino Female
Date of Death Age If Veteran of U.S. Armed Forces;
08 / 17 / 2017 70 War or Dates
Place of Death Hospital, Institution or
Z City, Town or Village Malta Street Address 224 Van Aernem Road
ctManner of Death❑Natural Cause 0 Accident Homicide E Suicide �Undetermined "—I Pending
CircumstancesInvestigation
ill Medical Certifier Name Title
a Jennifer Borden MD
Address
3044 New York 50, Saratoga Springs, NY 12866
Death Certificate Filed District Number Register Number
City, Town or Village Malta
><li ElBurial Date Cemetery or Crematory
08 / 18 / 2017 I Pine View Crematory
(Entombment Address
:iiip! Cremation Queensbury, NY
Date Place Removed
❑Removal and/or Held
ni and/or Address
ii
Hold
Date Point of
ti El Transportation Shipment
a by Common Destination
Carrier
Q Disinterment Date Cemetery Address
0gii
iiiil Reinterment Date , Cemetery Address
I
Permit Issued to Registration Number
Nii Name of Funeral Home Compassionate Funeral Care 00364
Address
402 Maple Ave. , Saratoga Sp. , NY 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
i
:: Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued E 1 21-. 4i 7 Registrar of Vital Statistics P � —y�,3 .—J
(signature)
District Number 104,,,,,:e", Place Malta , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
14
Z /�
Ili Date of Disposition g f Z�{t1Place of Disposition fintO�,, Gf9hc,ldtd.‘)
a (address)
ta
Cr (section) ,, (lot number) (grave number)
ciName of Sexton or Person ip Charge of Premises 6�(f S+�411-
Z (p ase print) •
t Signature a int. Title C -ACDR._
(over)
DOH-1555 (02/2004)