Sabo, Yvonne NEW YORK STATE DEPARTMENT OF HEALTI4
Vital Records Section Burial - Transit Permit
Name First Tlfddle Last Sex
Yvonne H Sabo Female
Date of Death Age If Veteran of U.S.Armed Forces,
i. May 20, 2011 86 War or Dates Iv
2 Place of Death Hospital, Institution or
W City,Town,or Village Argyle Street Address Pleasant Valley Nursing Home
O Manner of Death Natural Cause ❑ Accident ❑Homicide ❑Suicide ❑Undetermined ❑ Pending
W Circumstances Investigation
O Medical Certifier Name Title
W Dr. Barney Rubenstein, M.D. Dr.
0 Address
35 Gilbert, Cambridge, NY
Death Certificate Filed District Number 5 7 J V Register Number 36
City,Town or Village Argyle
❑Burial Date Cemetery or Crematory
May 24, 2011 Pineview Crematorium
❑Entombment Address
0 Cremation Queensbury, NY 12804
2 Date Place Removed
0 ❑Removal and/or Held
and/or Address
I' Hold
11) Date Point of
0 ❑Transportation Shipment
i by Common Destination
0 Carrier
Date Cemetery Address
O ❑Disinterment
El Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Jillson Funeral Home, Inc. 00897
Address
46 Williams Street, Whitehall, New York 12887
H Name of Funeral Firm Making Disposition or to Whom
ix ix Remains are Shipped, If Other than Above
W Address
0.
Permission is he eby gr nted to dispose of the human rema describ d a e as indicated.
Date Issued p-3 4 Registrar of Vital Statistics
(signature)
District Number 5 ? ) b Place Argyle,New York
F I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
W Date of Disposition 05/24/2011 Place of Disposition Pineview Crematorium
2 (address)
W
N
IY (section) (lot numbe ) (grave number)
0• Name of Sexton or Persoin Charge of Premises (Lsh .tr `t-vpt
W (please print)
Signature (PL. Title QfIh14rol--
(over)
DOH-1555 (02/2004)