Boccieri, Ronald NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
k.' RONALD J BOCCIERI Male
Date of Death 5/01/2015 Age If Veteran of U.S.Armed Forces,
83 War or Dates 06/10/1953 09/23/1955
Place of Death AlbanyHospital, Institution or
City, Town or Village Street Address DVAMC 113 Holland Avenue Albany, NY 12208
Manner of Death 0 Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending
£' Circumstances Investigation
Medical Certifier Name Title
Julie Phillips MD.
Address
113 Holland Avenue Albany, NY 12208
Death Certificate Filed District Number Register Number
_-_ City, Town or Village Albany 0198 068
❑Burial Date 1/, { , etery o Cremato
❑Entombment 041 ) c " ' rr V1 e � La tcrytalo rj
A ress , n
2 Cremation H t.tjajr� �u.,� V`I
Date Place Removed
❑
Removal and/or Held
and/or Address
Hold
Date Point of
❑Transportation Shipment
by Common Destination
Carrier
❑Disinterment
Date Cemetery Address
❑rReinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home 13,, p ,,,AA--- - - / ) y14_ [M)D0)-1
Address * (� rc k St Lo_ L1 Zp --1/
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human re of s sc ib d in 'cated.
Date Issued 5/01/2015 Registrar of Vital Statistics on /
(sign
District Number 0198 Place DVAMC, 113 Holland Avenue, Albany, New York 12208
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition S/1iir Place of Disposition Kati lair---
L.h
(address)
(section) (lot number) i (grave number)
Name of Sexton or Person in Charg of Premises
(p ase print)
Signature Title (IZ 1 t_
(over)
DOH-1555 (02/2004)