Hudson, Sally s 7
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
41 Name First Middle Last Sex
Sally L.Hudson Female
3 Date of Death Age If Veteran of U.S.Armed Forces,
04/18/2018 70 Years
War or Dates
Place of Death Hospital, institution or
City, Town or Village Saratoga springs Street Address Saratoga Hospital
Manner of Death 0 Natural Cause 0 Accident 0 Homicide 0 Suicide DUndetermined ri Pending
Circumstances Investigation
Medical Certifier Name Title
Desmond Delgiacco MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City, Town or Village Saratoga Springs 4501 242
Li Burial Date Cemetery or Crematory
04/23/2018 Pine View Crematory
❑Entombment Address
, ®Cremation Queensbury Town, New York
Date Place Removed
Removal and/or Held
and/or Address
Hold
Date Point of
Transportation Shipment
by Common Destination
Carrier
Date CemeteryAddress
4 0 Disinterment
Reinterment Date Cemetery Address
Permit Issued to Registration Number
'; Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human remains described above as indicated.
:. Date Issued 04/20/2018 Registrar of Vital Statistics John 2'Franck(E(ectronica((ysigned)
(signature)
District Number 4501 Place Saratoga Springs, New York
, I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
i Date of Disposition V1Si1i Place of Disposition C,11, irref..._
(address)
(section) j2/(lot number) (grave number)
I
Name of Sexton or Person in Charge of Premises l /1�� 54,--'ft
(pl se print)
,IT
, Signature d 4--
Title (POUF fi4.
(over)
DOH-1555 (02/2004)