Murphy, Alison NEW YORK STATE DEPARTMENT OF HEALTH- * A
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Alison Colleen Murphy Female
Date of Death Age If Veteran of U.S. Armed Forces,
03/10/2015 49 years War or Dates
Place of Death Hospital, Institution or
W City, ToMXX\MCORX Saratoga Springs Street Address Saratoga Hospital
a Manner of Death Lint Natural Cause El Accident El Homicide 0 Suicide ri Undetermined El Pending
i1 Circumstances Investigation
tu Medical Certifier Name Title
Robert Wang M D
Address
Death Certificate Filed District Number Register Number
City, TGANXX 4 X Saratoga Springs 4501 130
❑Burial Date Cemetery or Crematory
❑Entombment 03/1212015 Pine View Crematory
Address
gi[ Cremation Queensbury, N Y
Date Place Removed
Removal and/or Held
and/or
Address
Le
Hold
O Date Point of
Transportation Shipment
0 by Common Destination
Carrier
Q Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc. 00364
Address
402 Maple Ave., Saratoga Springs, N Y
s Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
• Address
tii
IL Permission is hereby granted to dispose of the human remains ibe aboThas indicated.
Date Issued 03/11/2015 Registrar of Vital Statistics f' -
(signature)
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:
Z r�
tip Date of Disposition 3/0115- Place of Disposition ,1tU-o C',,,.,` ^
2 (address)
lif
tO
(section) A(lot-number) (grave number)
a• Name of Sexton or Person in Charge of Premises y e �
( ase print)
.
a'
Signature Title C17.01/101
(over)
DOH-1555 (02/2004)