Kramberger, Carol NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
M Name First Middle Last Sex
Carol E. Kramberger Female
uj Date of Death Age If Veteran of U.S. Armed Forces,
January 12, 2011 77 War or Dates
Place of Death Hospital, Institution or
City, Town or Village Saratoga Springs Street Address Saratoga Hospital
Manner of Death Natural Cause Accident Homicide ❑ Suicide Undetermined pi Pending
Circumstances Investigation
Medical Certifier Name Title
Christopher D. Hoy, M.D. Dr.
Address
102 Park St. Glens Falls, NY 12801
Death Certificate Filed District Number ✓ Register Number
it Town or village SARATOGA SPRINGS �9 0/ 45
❑Burial Date Cemetery or Crematory
January 14, 2011 Pine View Crematory
❑Entombment Address
. ®Cremation Quaker Road Queensbury,NY 12804
Date Place Removed
Removal and/or Held
and/or Address
Hold
Date
by Common Destination
Point of
i Transportation Shipment
Carrier
❑ Disinterment Date Cemetery Address
❑ Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M.B. Kilmer Funeral Home 01097
Address
136 Main Street, South Glens Falls NY 12803
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human rem ' cr' ed abryea indicat
- Date Issued c� ► 1 I 9120 I Registrar of Vital Statistics I •
(signature)
District Number L-150, I Place SARATOGA SPRINGS
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition 01/14/2011 Place of Disposition Quaker Road Queensbury,NY 12804
(address)
(section) / (lot number) (grave number)
46 Name of Sexton or P h rson in Char of Premises L L ,lfz1 -SP NJti-
(please print)
Signature _. Title �kF'IVII4Tatl2-
(over)
DOH-1555 (02/2004)