Calhoun, Paul NEW YORK STATE DEPARTMENT OF HEALTH
# 30
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Paul William Calhoun Male
Date of Death Age If Veteran of U.S. Armed Forces,
• 06/25/2014 92 years War or Dates 1 944-1945
Place of Death Hospital, Institution or
W City, TOWRAXV;ihEaXX Saratoga S rings Street Address Sarato a Hos ital
W Manner of Death ,Natural Cause Accident ❑Homicide ❑Suicide Li Undetermined ❑Pending
Circumstances Investigation
tu Medical Certifier Name Title
o Carlos &Ares Md
Address
59 Myrtle St., Saratoga Springs, N Y
• Death Certificate Filed District Number Register Number
City, ToWRIMVAWI X Saratoga Springs 4501 991
❑Burial Date Cemetery or Crematory
❑Entombment 06/26/2014 Pine View Crematory
Address
❑,Cremation Oueensbury, N Y
Date Place Removed
Z ❑Removal and/or Held
2 and/or Address
F_ Hold
CO
O Date Point of
EL ❑Transportation Shipment
t�
0 by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
= LiPermit Issued to Registration Number
g. Name of Funeral Home Compassionate Funeral Care Inc. 00364
Address
402 Maple Ave., Saratoga Springs, N Y
Name of Funeral Firm Making Disposition or to Whom
14 Remains are Shipped, If Other than Above
';," Address
tr
UE
a` Permission is hereby granted to dispose of the human remain ib ab a - dicated
Date Issued 06/25/2014 Registrar of Vital Statistics •
(signature)
District Number 4501 Place S.arataga Springs
> _: I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
111 Date of Disposition (e/16l14 Place of Disposition 61-46(14"-,-
.2
(address)
In
to
CC (section) (lot numbe (grave number)
ci Name of Sexton or Per n in Charge of Premises 4,4 .1.-14
..air. (please print)
ILI
Si nature Title (4%��
(over)
DOH-1555 (02/2004)