Konig, Eleanor •
NEW YORK STATE DEPARTMENT OF HEALTH
tt 7
Vital Records Section
Burial Transit Permit
Name First Middle Last Sex
Eleanor Konig Female
Date of Death Age If Veteran of U.S. Armed Forces,
10 / 30 / 2016 89 War or Dates N/A
f Place of Death Hospital, Institution or
ZCity, Town or Village Saratoga Springs Street Address 51 Outlook Ave.
0 Manner of Death®Natural Cause Accident Homicide Suicide � Undetermined Pending
Circumstances Investigation
ig Medical Certifier Name Title
Tracey L. Brennan MD
Address
324 West Ave, Saratoga Springs, NY 12866
i>i Death Certificate Filed District Number 450 I Register Number
City, Town or Village Saratoga Springs
0Burial Date Cemetery or Crematory
11 / 01 / 2016 Pine View Crematory
z BEntombment Address
(>' ElCremation Queensbury, NY
Date Place Removed
A❑Removal and/or Held
and/or Address
Hold
Date Point of
Q Transportation Shipment
a by Common Destination
Carrier
Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
ii Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care 00364
Address
402 Maple Ave., Saratoga Sp., NY 12866
>: Name of Funeral Firm Making Disposition or to Whom
:i Remains are Shipped, If Other than Above
Address
IE
ILE
'"`: Permission is h reby granted to dispose of the human remai cri d abgr a 'ndicate .
Date Issued I I I Registrar of Vital Statistics
(signature)
District Number Lba 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 `�
tti Date of Disposition II13//t Place of Disposition Rat U,0 (�mc( _
ZE
ZE (address)
CA
IC (section) /(lot number) (grave number)
(pielAimit.4.."Name of Sexton or Person Charge of Premises �tn4/f
e print)
1 Signature Title /X OM
(over)
DOH-1555 (02/2004)