Aronson, Carol R
0 II 41 boy
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
rr:
Carol F. Aronson Female
Date of Death Age If Veteran of U.S. Armed Forces,
ig September 23, 2014 75 War or Dates
Place of Death Hospital, Institution or
City, Town or Village Saratoga Springs Street Address 11 Rolling Brook Dr.
ilz Manner of Death X Natural Cause 1 ]Accident 1 I Homicide Suicide Undetermined Pending
2 Circumstances Investigation
Medical Certifier Name Title
gi George Knapp MD
44.
IX Address
520 Maple Ave,Saratoga Springs,NY 12866
▪ Death Certificate Filed District Numbe4501 Register,Number
..
City, Town or Village Saratoga Springs 9 (p
•
❑Burial Date Cemetery or Crematory
September 24, 2014 Pine View Crematorium
II Entombment Address
❑x Cremation Quaker Road, Queensbury, NY 12804
Date Place Removed
Z Removal and/or Held
and/or Address
F' Hold
0
O Date Point of
NI ,I Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
: , Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Road, Queensbury, NY 12804
Name of Funeral Firm Making Disposition or to Whom
1; Remains are Shipped, If Other than Above
Address
, ..�, Permission is he eby g anted to dispose of the human rem d- cr' ed abp)r indicat d.
Date Issued Registrar of Vital Statistics
(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:
WDate of Disposition 9/1bliii Place of Disposition gaz..... 6w{c•r...
W (address)
CO
CL (section) /7 (lot numb fir) (grave number)
Q Name of Sexton or Person in Charge of Premises G hr,i L ,C- w--�
`Z (Please print)
Signature 4LI TitleCIPEO/Oreeg
(over)
DOH-1555(02/2004)