Greisler, Irene NEW YORK STATE DEPARTMENT OF HEALTH `
Vital Records Section Burial - Transit Permit
!iii Name First Middle Last Sex
Irene E. Greisler Female
Date of Death Age If Veteran of U.S. Armed Forces,
12 / 06 / 2016 58 War or Dates Nf
}- Place of Death Hospital, Institution or
Z City, Town or Village Providence Street Address 11' a Road
0 Manner of Death❑Natural Cause ®Accident Homicide Suicide Undeterr.� ®Pending
t Circum,'': es Investigation
tit Medical Certifier Name Title
Q Daniel J. Kuhn Coroner
Address
iiig 40 McMaster St. , Ballston Spa. , NY 120:
Death Certificate Filed District NumbeiLa q 'gister Number
MI City, Town or Village Providence 4
Date Cemetery or CrematoryBUrlal 12 / 09 / 2016
F View Crematory
QEntombment Address
Cremation Queensbury, NY
Date Place Removed
Z❑Removal and/or Held
Fo. and/or Address
1"`l Hold
VP.. Date Point of
rii 0 Transportation Shipment
ES by Common Destination
Carrier
" Q Disinterment Date Cemetery Address
0 Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home compassionate Funeral Care 00364
'< Address
402 Maple Ave. , Saratoga Sp. , NY 12866
igi Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
2 Address
te
,
'. Permission is h re y granted to dispose of the human re ins des rib abo as indicated.
illill Date Issued \ Oi \�p Registrar of Vital Statistics
( nature)
District Number Place Providence , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z.
til Date of Disposition /'2 fj2/j(, Place of Disposition ,?ig ,� e.„,J f�vric,lief/
2 (address)
III
{r (section) ` /' (lot number) (grave number)
IName of Sexton Pers n . Ch rge of Premises J� ��i -✓t 6aa e
Signature Title /2 L✓/c�11p/
(over)
DOH-1555 (02/2004)