Bell, Sophia NEW YORK STATE DEPARTMENT OF HEALTH
k Z70
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Sophia Margaret Bell Female
Date of Death Age If Veteran of U.S. Armed Forces,
04 / 07 / 2016 92 War or Dates N/A
i- Place of Death Hospital, Institution or
City, Town or Village Saratoga Street Address 280 Fitch Road
0 Manner of Death Natural Cause Accident 0 Homicide E Suicide 4-1 Undetermined �Pending
W. Circumstances Investigation
tu Medical Certifier Name Title
O. Richard L. Farrell MD
Address
15 Maple Dell # 1, Saratoga Springs, NY 12866
Death Certificate Filed District Number Register Number
City, Town or Village Saratoga5(.5
Pig 0Burial Date Cemetery or Crematory
04 / 07 / 2016 Pine View Crematory
Mi(Entombment Address
>' Cremation Z ' QU,A k Q.4r 0• Queensbury, NY
mi Date Place Removed
X 0 Removal and/or Held
and/or Address
Hold
Date Point of
❑Transportation Shipment
by Common Destination
Carrier
Mii Q Disinterment , !Date Cemetery Address
Q Reinterment Date Cemetery Address
ii$iii Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care, Inc 00364
Sil Address
402 Maple Ave., Saratoga Springs, NY 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
al Address
ir
ILI
Permission is hereby granted to dispose of the human remains described above as indicated.
rii
tiii. Date Issued La S'aO (P Registrar of Vital Statistics
(signature)
District Number =-f-5 (p 5 Place Saratoga , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
itt Date of Disposition q /g ll? Place of Disposition �� fur t-* V
ME (address)
til
Ir (section) /1 (lot number) CC (grave number)
CIName of Sexton or Person in Charge of P mises - (i jet-i�
Z► ( lease print)
Signature G Title I �"P
-
(over)
DOH-1555 (02/2004)