Fusco, Marguerite ;' 51 NEW YORK STATE DEPARTMENT OF HEALTH Burial _ Transit Permit
Vital Records Section
Name First Middle Last Sex
Marguerite Fusco Female
Date of Death Age If Veteran of U.S. Armed Forces,
07 / 12 / 2015 73 War or Dates N/A
14 Place of Death Hospital, Institution or
WCity, Town or Village Albany Street Address Albany Medical Center
0 Manner of Death 7 Natural Cause 0 Accident Li Homicide 0 Suicide ❑ Undetermined ❑Pending
In Circumstances Investigation
W Medical Certifier Name Title
Q Marc Judson MD
Address
47 New Scotland Ave, Albany, NY 12208
Death Certificate Filed District Number Register Number
lili City, Town or Village Albany 10/ )c,J i ff
>'>0Burial Date Cemetery or Crematory
07 / 14 / 2015 Pine View Crematory
r QEntombment Address
iiig ECremation 21 Quaker Road, Queensbury, NY 12804
Date Place Removed
Z❑Removal and/or Held
2 and/or Address
Hold
C Date Point of
tiQ Transportation Shipment
by Common Destination
Carrier
iiiigQ Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to l Registration Number
Name of Funeral Home Compassionate Funeral Care, Inc 00364
»< Address
402 Maple Ave., Saratoga Springs, NY 12866
iiiki Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
1
ILI
Permission is hereby granted to dispose of the human remains described above indicated.
« Date Issued a7//3/ 0/- Registrar of Vital Statistics , , ..2 C6 44....._-
(si ature)
NI District Number l p) Place Albany , New York
,,,,,` I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
111 Date of Disposition 1i t0fgc Place of Disposition . t(�, C ,c,i
2 (address)
11I
CrUl
(section) ///�/ (lot number) (grave number)
II Name of Sexton or Person in Char a of Premises L[,. ..St�
�+
► h�lease print) .
u Signature �" Title CIt 1I, 02
(over)
DOH-1555 (02/2004)