Trippi, Carol 1
f 5-13.
NEW YORK STATE DEPARTMENT OF HEALTH 3reP
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Carol Trippi Female
Date of Death Age If Veteran of U.S. Armed Forces,
05 / 12 / 2016 67 War or Dates N/A
}- Place of Death Hospital, Institution or
ZCity, Town or Village Saratoga Springs Street Address 9 Kirby Road Apt 22
a Manner of Death®Natural Cause 0 Accident 0 Homicide 0 Suicide ❑Undetermined IT❑Pending
Circumstances Investigation
in Medical Certifier Name Title
a Jennifer Keefer MD
Address
2531 Rte 9 Ste 20, Malta, NY 12020
:: Death Certificate Filed District Number ' Register Number
City,Town or Village Saratoga Springs _2
IfBurial Date Cemetery or Cr m5ato
05 / 13 / 2016 Pine View Crematory
Entombment Address
Cremation Query, NY
Date 'lace Removed
.Z Removal J and/or Hid and/or Address
t Hold
W Date Point of
gQ Transportation Shipment
a by Common Destination
Carrier
'"73 Date Cemetery Address
Q Disinterment
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, NY 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
. Address
2
t`' Permission is her y g nted to dispose of the human remain" crib d ab a 'ndicated
<:a Q
!; Date Issued Registrar of Vital Statistics
(signature)
District Number 9 5-11 Place Saratoga Springs , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition c j i>Ihi, Place of Disposition i 1L . L r eat-1 ,
(address)
La
Ca
at (section) lotnumber)e (grave number)
pName of Sexton or Person ip Char of Premises . of
2 (pie se print) .
Signature Title Cride"►N/94-
(over)
DOH-1555 (02/2004)