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Fredenburg, Ronald 61 1/ NEW YORK STATE DEPARTMENT OF HPAl.aTH,Vital Records Section Burial - Transit Permit Name First Middle Last Sex Ronald F. Fredenburg Male Date of Death Age If Veteran of U.S. Armed Forces, November 9, 2013 61 War or Dates 1 Place of Death Hospital, Institution or City, Town or Village Saratoga Springs Street Address Saratoga Hospital 10 W Manner of Death®Natural Cause Accident ❑Homicide 0 Suicide D Undetermined ❑Pending Circumstances Investigation W Medical Certifier Name Title CI Desmond DelGiacco MD Address 59 Mrytle St. Saratoga Springs, NY 9gath Certificate Filed District Number Register Number ,'City�Town or Village SARATOGA SPRINGS �..5 / ❑Burial Date Cemetery or Crematory November 12, 2013 Pine View Crematory ❑Entombment Address ©Cremation 21 Quaker Rd, Queensbury, NY 12804 Date Place Removed Z n Removal and/or Held C and/or Hold Address i O Date Point of ❑Transportation Shipment a by Common Destination Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address Ei Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd, Queensbury, NY 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above • Address tLI IL Permission is hereby granted to dispose of the human remains ibe aboi as indicated. Date Issued Registrar of Vital Statistics - -4-riu.,ru.,Z (signature) District Number /ISGf Place SARATOGA SPRINGS t_H>.::::: I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ill• Date of Disposition ,/f,C r„� Place of Disposition ` ltc- (/ ' C.ii s. /9-4 1 W (address) rc (section) �( f� number) / (grave number) Name of Sexton - Charge of Premises 14/// /ife1 (please print) W. Signat � �`" � Title , -' (over) DOH-1555 (02/2004)