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Mcgovern, William 1, LI, NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex William Mcgovern Male # ' Date of Death Age If Veteran of U.S. Armed Forces, 08/20/2017 59 Years War or Dates 2 Place of Death Hospital, Institution or City, Town or Village Saratoga springs Street Address Saratoga Hospital Manner of Death©Natural Cause 0 Accident 0 Homicide EI Suicide 0Undetermined ri Pending 1 Circumstances Investigation Medical Certifier Name Title Rodney Ying MD Address 211 Church St,Saratoga Springs,New York 12866 Death Certificate Filed District Number Register Number City, Town or Village Saratoga Springs 4501 405 ❑BUrlal Date Cemetery or Crematory 08/22/2017 Pine View Crematory ❑Entombment Address ®Cremation Queensbury Town, New York Date Place Removed fl El Removal and/or Held gand/or Address Hold Date Point of - -i ❑Transportation Shipment by Common Destination Carrier E Disinterment Date Cemetery Address Q Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Compassionate Funeral Care Inc 00364 Address 402 Maple Ave,Saratoga Springs,New York 12866 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address 'h Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/22/2017 Registrar of Vital Statistics Johnc1'Franck TElectronicallySigner (signature) District Number 4501 Place Saratoga Springs, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: i' Date of Disposition 4 f 23)n Place of Disposition fink V ivi 1:wn4' +r+w (address) (section) (lot number) c ( print) (grave number) Name of Sexton or Person in Charge of Pr ises p/e a p Signature yvt) Title fPE47f9L (over) DOH-1555 (02/2004)