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Brundige, Minna #70 NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name Firs�lnna Middle V. L srundige Sex Female Date of Death Age If Veteran of U.S. Armed Forces, 02/01/2014 99 years War or Dates 1. Place of Death Hospital, Institution or City, T ?lr t Saratoga Springs Street Address Wesley Health Care Center W Manner of Death©Natural Cause ❑Accident El Homicide El Suicide ❑Undetermined ❑Pending Circumstances Investigation W Medical Certifier Name Title C Rick D. Teetz M. D. Ad elsLsawrence Street, Saratoga Springs N Y Death Certificate Filed District Number Register Number City, T &r 4f Saratoga Springs 4501 56 rizi ❑Burial Date Cemetery or Crematory 02/04/2014 Pine View Crematory ['Entombment Address ©Cremation Queensbury N Y Date Place Removed Z ❑Removal and/or Held 9. and/or Address 12: Hold U) W Date Point of t Transportation Shipment i3 by Common Destination Carrier ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address_ I Permit Issued to Registration Number Name of Funeral Home Compassionate Care, Inc. 00364 Address 402 Maple Avenue, Saratoga Springs, N Y 12866 Name of Funeral Firm Making Disposition or to Whom I . Remains are Shipped, If Other than Above Address CC Ili 1' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/04/2014 Registrar of Vital Statistics q, Q.,,,,, . —4- 4AANS, signature District Number 4501 Place Saratoga Springs I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z lL I Date of Disposition Q/b j14 Place of Disposition FIV 44 6,4),(......... 2 (address) Ui rE (section) (lot number) (grave number) DName of Sexton or Person i Charge of Premises frV,••• 3#AAA se print) iti. Signature ,' Title CiL<t+tol0t (over) DOH-1555 (02/2004)