Tallman, Hilton NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Hilton A Tallman Male
Date of Death Age If Veteran of U.S. Armed Forces,
08 / 28 / 2015 92 War or Dates 1943-1946
}- Place of Death Hospital, Institution or
Z City, Town or Village Saratoga Springs Street Address Wesley Health Care Center
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a Manner of Death Natural Cause E Accident 0 Homicide —_Suicide 0 Undetermined 0 Pending
ILI Circumstances Investigation
ill Medical Certifier Name Title
O Rick D. Teetz MD
Address
1134 NY-29, Greenwich, NY 12834
ai Death Certificate Filed District Number Register Number
Viy City, Town or Village Saratoga Springs
Mrm BUrlal Date Cemetery or Crematory
08 / 28 / 2015 Pine View Crematory
, ,.,:Q Entombment Address
EiCremation 21 Quaker Road, Queensbury, NY
Date Place Removed
1 0 Removal and/or Held
and/or Address
Hold
ill Date Point of
iiQ Transportation Shipment
by Common Destination
Carrier
Q Disinterment Date Cemetery Address
!011iiiiigi
;::1
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
vi
Name of Funeral Home Compassionate Funeral Care, Inc 00364
Address
402 Maple Ave., Saratoga Springs, NY 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
X. Address
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UI
• Permission is hereby granted to dispose of the human remain cri d abor ndicate
Iii? Date Issued 817 115 Registrar of Vital Statistics
(signature)
Ni
District Number I Place Saratoga Springs , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
tii• Date of Disposition Qb)lyc Place of Disposition *v i (, 0r4.01
(address)
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kg (section) ✓,,Blot number) r (grave number)
Name of Sexton or Person in Charge of Premises 4 ril o rf
,2►• (pie se print) •
Signature Title Ifir4101
(over)
DOH-1555 (02/2004)