Allen Sr, Neil G. NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Biostatistics - Vital Records Section
Name First Middle Last Sex
•Neil G. Allen Sr. ma
Date:o::. ............................. .............................................................
f Death Age If Veteran of U.S.armed Forces,
March 29 1 988 53 WarorDates Korean
Place of Death Hospital, Institution or
City,Town or Village Saratoga Springs Street Address Saratoga Hospital
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i Ca ..........................................
use of Death
Ill Widley metastic carcinoma of Prostate
Medical Certifier Name .................:...::.:::,::::::::::.::::::.::::
ai3 Title
Ct John Cetner Dr.
..................................... Address.....:......................................................................................................................................................................................................
3 Myrtle St Saratoga Springs, N.Y. 12$66
Deatti::..:e.::... ......................
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Certificate Filed District Number Register Number
City,Town or VillageMarch 30, 1988 4501 123
Date Cemetery or Crematory
El Burial March 0 1
.......... .............3....,.. 9$$....:............:. Fine View Crematorium
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Address
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:
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cremation Quarker Rd. Town of Queensbury
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Z Date Place Removed
O' ❑ Removal
and/or Held
F- and/or Hold :...............:..:..........:..... ..:..........................:.
Address
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cn ❑Transportation by Date
Point of
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Common Carrier .. Shipment
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Destination
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❑ Disinterment Date Cemetery Address
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❑ Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Firm William J. Burke & Sons 88300
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Address .
628 N. Broadwa S
y, arato a s rin s
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
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Address
4'
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Permission is hereby granted to dispose of the dead, human/remains os gibed a ve as indicated.
Date Issued March 30.19$BRegistrar of Vital Statistics �- 1f� ''C� �-� ,
(signature)
District Number 4501 Place Saratoga Springs, N.Y.
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
H
W Date of Disposition " " Place of Disposition 2?
(address)
w
M
oC (section) (lot number) /grave number)
p Name of Secton or arson in barge of Premi s �
ut Signature lease print)Title -z-
551 j
DOH- 1555(9/86)p 1 of 2(formerly VS-61)