Filkins, Joan - ./6-7
NEW YORK STATE DEPARTMENT OF HEALTH . �, Ith
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joan Filkins Female
Date of Death Age If Veteran of U.S. Armed Forces,
03/18/2014 67 years War or Dates
- Place of Death Hospital, Institution or
6 City, Towt */iIXX Glens Falls Street Address The Pines at Glens Falls Center
WManner of Death $atural Cause El Accident ❑Homicide ❑Suicide ❑Undetermined ri❑Pending
Circumstances Investigation
W Medical Certifier Name Title
n William Parker Physician
Address
88 Broad Street Glens Falls, NY 12801
Death Certificate Filed District Number Register Number
City, Towg fiI XX Glens Falls 5601 133
['Burial Date Cemetery or Crematory
❑Entombment 03/20/2014 Pine View Crematory
Address
pCje mat ion Queensbury, NY
Date Place Removed
�71 Removal and/or Held
and/or Address
Hold
0 Date Point of
t
Transportation Shipment
a by Common Destination
Carrier
Q Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
. LiPermit Issued to Registration Number
i 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
2 Address
tr
W
LL
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 03/20/2014 Registrar of Vital Statistics tA)c,j.A4y Q.
(signature)l)
District Number Place
5601 Glens Falls 1 N yi
• I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
ill Date of Disposition Mkt Place of Disposition '(v (i& `n�c*pew,,
(address)
lid
th
IX (section) (lot num ) (grave number)
• Name of Sexton or Person in Ch rge of Premises 4}et, ...411
2 1 (please print)
Signature > Title Lego
(over)
DOH-1555 (02/2004)