McLaughlin, Joan NEW YORK STATE DEPARTMENT OF HEALTH 0
Vital Records Section Burial - Transit Permit
iipli Name First Middle Last if A Sex
Joan C. McLaughs ,. 2�Gt_ Female
Date of Death Age If Veteran of U.S. Armed Forces,
08 / 05 / 2015 76 War or Dates N/A
14 Place of Death Hospital, Institution or
ZCity, Town or Village Schenectady Street Address Ellis Hospital
0 Manner of Death El NaturalCause El Accident Homicide E Suicide 0 Undetermined n Pending
ItiCircumstances Investigation
0.
Lti Medical Certifier Name R ' Je Title
eii Address l/0 1 OH c7 DJUi-)et-Itt(4.,1,-<` Death Certificate Filed District Number Register u ner
City, Town or Village Schenectady L{(1 6 i
oBurial Date Cemetery or Crematory
08 / 10 / 2015 Pine View Crematory
->' UEntombment Address
IZCremation 21 Quaker Road, Queensbury, NY
Date Place Removed
M Ri---,
Removal and/or Held
and/or Address
it Hold
Date Point of
Q Transportation Shipment
a by Common Destination
Carrier
Q Disinterment Date Cemetery Address
i!iiil: Reinterment Date Cemetery Address
Ni Permit Issued to Registration Number
i.iiiq Name of Funeral Home Compassionate Funeral Care, Inc 00364
Address
Mil 402 Maple Ave. , Saratoga Springs, NY 12866
Name of Funeral Firm Making Disposition or to Whom
•"h Remains are Shipped, If Other than Above
Address
it
in
Pi Permission is eby granted to dispose of the human remains e ribs abov a in 'ca
im
Date Issued KJ(Q !j '3 Registrar of Vital Statistics `/ 1/l
C
(`;nature)
District Number U I Place Schenectady , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
10#Z
tii Date of Disposition 11101 I[SPlace of Disposition .4a..) C ,....,,
Z (address)
III
V
(section) /(lot number) (grave number)
ci Name of Sexton or Person " Charge Premises -. h� St�+44
H
,�►• (plefase print) •
Signature Title r
-
(over)
DOH-1555 (02/2004)