Finn, Barbara NEW YORK STATE DEPARTMENT OF HEALTH 1 tie 1 `
Vital Records Section Burial - Transit P rmit
Name Firi3arbara Middle�uth Last Sex�lale inn
Date of Death Age If Veteran of U.S. Armed Forces,
02/20/2013 76 years War or Dates
Place of Death Hospital, Institution or
W City, -pby46(omcgioc Saratoga Springs Street Address Saratoga Hospital
a Manner of Death Natural Cause ElAccident 1=1Homicide El Suicide 0 Undetermined 0 Pending
In Circumstances Investigation
W Medical Certifier Name Title
a Richard Kim M D
A9r1eurch Street, Saratoga Springs, N Y 12866
Death Certificate Filed District Number Register Number
City, AKeigiXo0NikiEft Saratoga Springs 4501 98
DBurial Date Cemetery or Crematory •
02/22/2013 Pine View Cemetery
❑Entombment Address
::EICremation Queensbury N Y .
Date Place Removed
, , IT Removal and/or Held
and/or
Address
CO
Hold
0 Date Point of
grk❑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
I Remains are Shipped, If Other than Above
2 Address
it
ttl
fl` Permission is hereby granted to dispose of the human remains described above as indicated.
iliE Date Issued 02/22/2013 Registrar of Vital Statistics
(signhtur )
ia 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:
2 p� r
tt Date of Disposition 2"lc-13 Place of Disposition �n4V,h,J awls .
ss t
ILI
CA
CC (section) (lot numbe (grave number)
Name of Sexton or Person in Charge of Premises A,,t,,,L. �tndt
2 (please print)
iti
Signature `� A_,---- Title C�EM14�i]� —
(over)
DOH-1555 (02/2004) '