Loading...
Krywy, Linda NEW YORK STATE DEPARTMENT OF HEALTH I' Sb Vital Records Section Burial - Transit Permit Name First M. Krywy Female Date of Death Age If Veteran of U.S. Armed Forces, 12/11/2013 56 years War or Dates }- Place of Death Hospital, Institution or ii City, TWArXinitjaC Saratoga Springs Street Address Saratoga Hospital a Manner of Death©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined El Pending iii Circumstances Investigation W Medical Certifier Name Title 0 Heather Madigan M. D Ac li i hurch Street, Saratoga Springs, N Y 12866 Death Certificate Filed District Number Register Number City, TainirMUX6eX Saratoga Springs 4501 513 ❑Burial Date Cemetery or Crematory 12/12/2013 Pine View Crematory ::❑Entombment Address ECremation Queensbury N Y Date Place Removed • Removal and/or Held 21-1 and/or Address Hold th 0 Date - Point of t! Transportation Shipment 0 by Common Destination Carrier ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address 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 Remains are Shipped, If Other than Above ;; Address t • :: Permission is hereby granted to dispose of the human remai cri d abo e a indicate . ill Date Issued 12/11/2013 Registrar of Vital Statistics r. (signature) 15 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. ILI IF Date of Disposition oJ►3iv, Place of Disposition Rixkliv rrc) r,,.- (address) U 0 1E (section) //lot number) (grave number) • Name of Sexton or Person Charge of Premises tit i*d �,HH (ple se print) Signature c.� Title atElliff Z f (over) DOH-1555 (02/2004)