Kindl, Joan 4 ' _
'171
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joan Y. Kindl Female
Date of Death Age If Veteran of U.S. Armed Forces,
07 / 12 / 2016 84 War or Dates N/A
14 Place of Death Hospital, Institution or
ZCity, Town or Village Malta Street Address Home of The Good Shepherd
a Manner of Death® Natural Cause 0 Accident 0 Homicide Suicide ❑Undetermined ❑Pending
Circumstances Investigation
tg Medical Certifier Name Title
Q Dr. Jennifer Keefer MD
Address
2537 Route 9 Suite 213, Malta, NY 12020
Death Certificate Filed District Number Register Number
City, Town or Village Edlta
qie DBurial Date I Cemetery or Crematory
07 / 13 / 16 Pine View Crematory
<s% DEntombment Address
CCremation LI O All/fa , MAP Queensbury, NY IL$01
Date Place Removed
Removal and/or Held
? and/or
Address
Hold
O.
0 Date Point of
Q Transportation Shipment
C by Common Destination
Carrier
:::j:Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
ig Permit Issued to I Registration Number
Name of Funeral Home Compassionate Funeral Care, Inc 00364
Address
PR 402 Maple Ave., Saratoga Springs, NY 12866
giiii Name of Funeral Firm Making Disposition or to Whom
• Remains are Shipped, If Other than Above
2 Address
111
LL`. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 7, L .J4i Registrar of Vital Statistics �araie,.:47_, ,/c.44 A� �
/(snature)
District Number ,ti_l40 Place Malta , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
i .
iti Date of Disposition /I I1.(04 Place of Disposition .PatOw) ensdto-^.
id (address)
fil
CE (section) 4-70"1"Le
pot number) < (grave number)
0 Name of Sexton or Person ip Charge of Pr mises J(,MI1
�► ( lease print) .
t Signature Title rit
(over)
DOH-1555 (02/2004)