Harrington, Stryker NEW YORK STATE DEPARTMENT OF HEALTH �J)
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Stryker D Harrington Male
Date of Death Age If Veteran of U.S. Armed Forces,
11/25/2014 0 years_ War or Dates
1- Place of Death Hospital, Institution or
z City, TowAxxXilkICXXX Glens Falls Street Address Glens Falls Hospital
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Manner of Death❑Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending
ILI Circumstances Investigation
W Medical Certifier Name Title
C Patricia A. Sayer M. D.
Address
100 Park Street Glens Falls, Ny 12801
Death Certificate Filed District Number Register Number
City,TowXXXX'iIkNXXX Glens Falls 5601 t
. ❑Burial Date Cemetery or Crematory
❑Entombment 11/30/2014 Pine View Crematorium
Address
❑Cremation Queensbury, NY 12804
Date Place Removed
Z❑Removal and/or Held
.,.., and/or Address
I-, Hold
N
0 Date Point of
25 ❑Transportation Shipment
Gl by Common Destination
Carrier
❑Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care 00364
Address
402 Maple Street Saratoga Springs, NY 12866
,, Name of Funeral Firm Making Disposition or to Whom
1 . Remains are Shipped, If Other than Above
Address
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Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/01/2014 Registrar of Vital Statistics L.'J clAi yNst.
(sign/
District Number 5601 Place Glens Falls
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
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to Date of Disposition I'LI LI iN Place of Disposition ,(,,.. 6 4,r0.-
2 (address)
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CC (section) A
(lot number) (grave number)
a Name of Sexton or Perso in Char a of Premises S a,..c
2 (please print)
StIA i nature C� 1 Title C wit6114(
9
(over)
DOH-1555 (02/2004)