Sabo, Sabo NEW YORK STATE DEPARTMENT OF HEALTH : 'N, it 142
Vital Records Section Burial - Transit Permit
N• ame First Middle Last Sex
Sabo oe Sabo male
9� Date of Death Age If Veteran of U.S. Armed Forces,
March 5, 2015 81 War or Dates 1052-54
Place of Death Hospital, Institution or
CCity, Tosmooltiec Glens Falls Street Address Glens Falls Hospital
Cr Manner of Death® Natural Cause ❑ Accident ❑ Homicide 0 Suicide ❑ Undetermined ❑ Pending
o Circumstances Investigation
i-- Medical Certifier/ Name Title
+ ,lt 11, 4 �p:—y 0_1 C
Address
.e_ c s L 0
D• eath Certificate Filed District Number Register Number --
City, Tiftig & Glens Falls 5601 ( Z S
❑Burial Date Cemetery or Crematory
Marcg 6, 2015 Pine View Crematorium
❑Entombment Address
A3
['Cremation Tn of Queensbury, NY
- Date Place Removed
IT❑ Removal and/or Held
and/or Hold Address
Date I Point of
❑Transportation i_ ,hipment
by Common Destination
a Carrier
❑ Disinterment
Date Cemetery Address
❑ Reinterment Date Cemetery Address
P• ermit Issued to Registration Number
Name of Funeral Home Carleton Funeral Home, Inc. 00281
`. Address
68 Main St., Hudson Falls, NY 12839
• Name of Funeral Firm Making Disposition or to Whom
} Remains are Shipped, If Other than Above
Address
W°
41": Permission is hereby granted to dispose of the human remains described above as indicated.
• Date Issued 3 161 t 5 Registrar of Vital Statistics LA CA,�,y� 1.�--�"< 4
(signature)
District Number 5601 Place City of Glens Falls, NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
L,LL` Date of Disposition •3e`►(fs- Place of Disposition eiu, Cr s --
(address)
3,
(section) (Icy number) �v�� (grave number)
• Name of Sexton or Person in Czi Aharge of Premises ,‘•
(pleas print)
Signature Title aXM1I!
(over)
DOH-1555 (02/2004)