Garrison, Donald It . , z39
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Donald E. Garrison Male
Date of Death Age If Veteran of U.S. Armed Forces,
03 / 22 / 2017 90 War or Dates 1945-1946
14 Place of Death Hospital, Institution or
ZCity, Town or Village Saratoga Springs Street Address Saratoga Hospital
0 Manner of Death LE Natural Cause E Accident Homicide 0 Suicide 0 Undetermined 7 Pending
Circumstances Investigation
tii Medical Certifier Name Title
44 Zeshan Latif MD
Address
> 7 211 Church Street Saratoga Springs, NY 12866
Death Certificate Filed District Number ii tC I Register Number
City, Town or Village Saratoga Springs )L fl._
s CIBurial Date Cemetery or Crematory
03 / 23 / 2017 Pine View Crematory
Entombment Address
mi ECremation Queensbury, NY
Date Place Removed
Z❑Removal and/or Held
and/or Address
Hold
Date Point of
Q Transportation Shipment
by Common Destination
in Carrier
El Disinterment Date Cemetery Address
>'Q Reinterment Date Cemetery Address
[ Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care 00364
<< Address
WA 402 Maple Ave., Saratoga Sp. , NY 12866
<i Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Cr
ILI
4.0
Permission is h reby ranted to dispose of the human re • sc ' ed air indica d.
Date Issued �j 4� � Registrar of Vital Statistics 1"
(signature)
)
District Number it0 Place Saratoga Springs , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
Iii Date of Disposition 3 .77 Place of Disposition PPV--l..0-44)e..../2frA-11.-h
(address)/
ILI
Ir (section) lot number) (grave number)
0 Name of Sexton o . Charge of Premises \ w:I(�� 6e, Alm e
,Z► �' (please nnt) •
ilif Signature ( " Title C r'12,1
(over)
DOH-1555 (02/2004)