Seddon, Betty Lou r.. 1\°A.
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Betty Lou Seddon Female
Date of Death Age If Veteran of U.S.Armed Forces,
10/09/2020 82 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Saratoga Town Street Address 153 Southard Road, Saratoga Town, New York 12866
p Manner of Death ❑X Natural Cause Accident ❑ Homicide Suicide pi UndeterminedEl Pending
Circumstances Investigation
W Medical Certifier Name Title
CI Susan Dorsey MD
Address
1 West Avenue,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Schuylerville 4565 8
Burial Date Cemetery,Crematory or Facility Name
10/09/2020 Pine View Crematory
Entombment Address
X❑Cremation Queensbury Town,New York
Donation
IS Removal Date Place Removed
and/or and/or Held
F— Hold Address
O
d Date Point of
co Li Transportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
I— Remains are Shipped,If Other than Above
Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/09/2020 Registrar of Vital Statistics LindiJi Wccaie( ctronicaIl Signed!)
(signature)
District Number 4565 Place Schuylerville, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on.
H I/
WDate of Disposition /D J13f70 Place of Disposition l��L
2 (a dress)
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CC
CC (section) t number) (grave number)
0 Name of Sexton or Person in Charge remises h �'
Z / plea
Ui rint/
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Signature Title ' ►
DOH-1555(07/18)p t of 2
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Public Health Law Sec. 4145(2b) 014 a 9
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Receipt
Human remains of delivered on , 20
Pine/View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License# ` fr