Sanders, Karen NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Karen Marcia Filkins- Sanders Female
Date of Death Age If Veteran of U.S. Armed Forces,
06/06/2015 50 years War or Dates
15i . Place of Death Hospital, Institution or
City, Toq( 4CCX Saratoga Springs Street Address West Ave At Congress Ave.
Manner of Death❑Natural Cause ❑Accident ❑Homicide ElSuicide ❑Undetermined ❑Pending
UI Circumstances Investigation
w Medical Certifier Name Title
Daniel J. Kuhn Coroner
Address
40 McMaster Street, Ballston Spa, N Y 12020
Death Certificate Filed District Number Register Number
City, Tov(XXKC DETXX Saratoga Springs 4501 285
❑Burial Date Cemetery or Crematory
❑Entombment 06/11/2015 Pine View Crematory
Address
❑,Cremation Queensbury, N Y
Date Place Removed
Z Removal and/or Held
2 �and/or Address
H Hold
0 Date Point of
glq❑Transportation Shipment
▪ by Common Destination
Carrier
El Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Bakers Funeral Home 01130
Address
11 Lafayette Street, Queensbury, Ny
Name of Funeral Firm Making Disposition or to Whom
,�- Remains are Shipped, If Other than Above
• Address
#Z
1I
Permission is hereby granted to dispose of the human rema' cri d Ware indicate .
Date Issued 06/08/2015 Registrar of Vital Statistics
(signature)
dii District Number 4501 Place Saratoga Springs
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
ILI Date of Disposition i,-11.-(Ss Place of Disposition '(es4 .,,,, C
' ► (address)
UI
CO
>i (section) (lot number (grave number)
DName of Sexton or Person in Ch of Premises
Z (please print)
• Signature Title frivvtl F34
(over)
DOH-1555 (02/2004)