Maningas, Mario NEW YORK STATE DEPARTMENT OF HEALTH If
Vital Records Section Burial - Transit rmit
Name Fir aria Middlb Maningas Sex.
Male
Date of Death Age If Veteran of U.S. Armed Forces,
M. 06/07/2013 72 years War or Dates
I- Place of Death Hospital, Institution or
j City, lieWiXontiNaglk Saratoga Springs Street Address Saratoga Hospital
its Manner of Death 0 Natural Cause ❑Accident ❑Homicide ❑Suicide El Undetermined ❑Pending
UJ Circumstances Investigation
W Medical Certifier Name Title
Joseph� e W. Bell MD
AY West Ave, Suite 125, Saratoga Springs, NY 12866
Death Certificate Filed District Number Register Number
City, o?iJ Saratoga Springs 4501 254
['Burial Date Cemetery or Crematory
06/11/2013 Pineview Crematory
,4['Entombment Addr es-As S.,,
:f IjCremation Y
Date Place Removed
Z riRemoval and/or Held
9 and/or Address
ill.
. Hold
Date Point of
i Transportation •Shipment
a by Common Destination •
Carrier
❑Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Re ig_stration Number
Name of Funeral Home Densmore Funeral Home • 00448
Address
7 Sherman Ave, Corinth, New York 12822
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
I
IL./•
' Permission is hereby granted to dispose of the human remai ri abop 'ndicate
Date Issued 06/10/2013 Registrar of Vital Statistics
(signature)
gt District Number 4501 Place Saratoga Springs
I certify that the remains of the decedent identified above e disposedl of in accordance with this permit on:
tLl Date of Disposition 6.--/,01-i7 Place of Disposition ) I' ' " C , I..,fix
a (address)
tii
IX (section) � (grave number)
o
Name of Sexton Perso -n • • g- of Premises �C / fz::::7,nber,
` e
w . �C/ (please print) /
Signature Title ��.,.�,o�d� 7 A
(over)
DOH-1555 (02/2004)