MacWhinnie, Patrick . . 1
NEW YORK STATE DEPARTMENT OF HEALTH /ti
Vital Records Section -wk Burial - 16Iransit Permit
Name First Middle Last Sex
Patrick MacWhinnie Male
Date of Death Age If Veteran of U.S. Armed Forces,
03 / 12 / 2016 54 War or Dates N/A
}- Place of Death Hospital, Institution or
Z City, Town or Village Wilton Street Address 4376 Rte 50
0 Manner of Death®Natural Cause Accident 0 Homicide E Suicide �Undetermined �Pending
ItiCircumstances Investigation
la Medical Certifier Name Title
David Mastrianni MD
Address
3 Care Lane, Suite 300 Saratoga Springs, NY 12866
Death Certificate Filed District Number Register N /rr?ber
City, Town or Village Wilton 9 /u
„ fBurial Date • Cemetery or Crematory
I03AJ Pine View Crematory
/ 15 / 2016
<' In Entombment Address
ECremation Queensbury, NY
Date Place Removed
8 7❑Removal and/or Held
and/or Address
Hold
Date Point of
Transportation Shipment
by Common Destination
Carrier
giiliQ Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care, Inc 00364
Address
>'>'.3 402 Maple Ave., Saratoga Springs, NY 12866
z` Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
5
Permission is hereby ranted to dispose of the human remains described b9 s indicated.
iai
Date Issued Registrar of Vital Statistics j11' i/l1
nature)
gii
District Number XV,i'
Place Wilton , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
lit p /A, DispositionjetJp,, t ► M—Date of Disposition 3 j�b Place of
2 (address)
fili
ca
i (section) // (lot numbed (grave number)
ilk Name of Sexton or Person ip Charge Premises !�s ✓�
Z ? ( ase print) •
Signature Title /4 ifit
(over)
DOH-1555 (02/2004)