Flynn, Kerry t
NEW YORK STATE DEPARTMENT OF HEALTH ___ 63�_
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Kerry Flynn Female
<'< Date of Death Age If Veteran of U.S. Armed Forces,
09 / 06 / 2016 54 War or Dates N/A
}- Place of Death Hospital, Institution or
21 City, Town or Village Saratoga Springs Street Address Saratoga Hospital
Q Manner of Death®Natural Cause 0 Accident 0 Homicide El Suicide Undetermined ri Pending
ti Circumstances Investigation
tij Medical Certifier Name Title
iQ Numan Rashid MD
Address
317 S Manning Blvd, Albany, NY 12208
Death Certificate Filed District Number Register Number
iiM City,Town or Village Saratoga Springs 5b 1 C.J
iliii 0Burial Date Cemetery or Crematory /
09 / 07 / 2016 Pine View Crematory
0 Entombment Address
®x Cremation Queensbury, NY
Date Place Removed
Z❑Removal and/or Held
g riand/or Address
#t
Hold
0 Date Point of
R` Transportation Shipment
a by Common Destination
Carrier
Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Viiii Name of Funeral Home Compassionate Funeral Care 00364
iAii Address
402 Maple Ave., Saratoga Sp. , NY 12866
"> Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
2 Address
1r
iii
Permission is he by granted to dispose of the human re i a8
rirrAcietik-
>i' Date Issued Ci � (�1 Registrar of Vital Statistics
(signature)
mi District Number l Sol Place Saratoga Springs , New York
1-
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on;
Z
111 Date of Disposition 9(g/lL Place of Disposition 'tO`r,,/ •.
(address)
ttl
fill
CC (section) (lot number) (grave number)
4 dicsitiL -
Q Name of Sexton or Person ill Charge of P emises �r 3iAnit
Z lease pnnt) •
Signature aTitle �OlI11K •
•
(over)
DOH-1555 (02/2004)