Papero, Murray NEW YORK STATE DEPARTMENT OF HEALTH ` # /n
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Murray Anthony Papero Male
Date of Death Age If Veteran of U.S. Armed Forces,
December 18, 2016 62 War or Dates N/A
14 Place of Death Hospital, Institution or
u City, Town or Village Saratoga Springs Street Address 17 Walworth Street
Manner of Death pli Natural Cause ❑Accident ❑Homicide ❑Suicide ri❑Undetermined ri❑Pending
Ili Circumstances Investigation
Medical Certifier Name Title
Q Michael Sikiricca MD
Address
40 McMaster Street, Ballston Spa, NY 12020
Ni Death Certificate Filed District Number Register Number
iM City, Town or Village Saratoga Springs 4501
❑Burial Date Cemetery or Crematory
12/21/2016 Pineview Crematory
iii ❑Entombment Address
iiN®Cremation Quaker Road Queensbury, NY 12804
Date Place Removed
Z ❑Removal and/or Held _
1 and/or Address
F= Hold
to
O Date Point of
Transportation Shipment
C by Common Destination
Carrier
Disinterment Date Cemetery Address
M ElDili
Reinterment Date Cemetery Address
Mi Permit Issued to Registration Number
MIName of Funeral Home Compassionate Funeral Care, Inc. 00364
Address
402 Maple Avenue, Saratoga Springs, NY 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
• Address
tr
ttt P` Permission is hereby granted to dispose of the human remai cri d alter indicate .
Date Issued 12/20/2016 Registrar of Vital Statistics
(signature)
District Number 4501 Place City Hall, Saratoga Springs, NY 12866
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
ILI• Date of Disposition !z`zi /ib Place of Disposition °I ntIIa✓ ` mom
a (address)
Lu
CA
CC (section) rirlAlpi,,-
got number - (grave number)
tt Name of Sexton or Person inCharge of Premises tiit -,
(pfO 3ase print)
41„iiSignature et Title ( nittoil
(over)
DOH-1555 (02/2004)