Williams, Marie L NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Biostatistics -Vital Records Section
Name First Middle Last Sex
Marie L. Williams Female
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at
D e of Death Age If Veteran of U.S.Armed Forces,
<. Feb. 23,1989 82 War or Dates
Place of Death Hospital, Institution
City,Town or Village Saratoga Springs Street Address Wesley Health Care Center
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se of Death
Cardio-Vascular Accident
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Medical Certifier Name Title
'Q James Noonan Dr.
Address
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42 Myrtle St. Saratoga Springs,N.Y. 12866
Death Certificate Filed District Nm gr Register Number
`<> city,Town or Village Saratoga Springs 1
Date Cemetery or Crematory
❑Burial Feb.23,1989 ; Pine View Crematorium
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Queensbury, N.Y.
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z Place Removed
❑ Removal ': and/or Held
and/or Hold' :::.::::......:::::::::::.::::::::::.....::::::::::::::::::::::::::::::......:::>:::::::::::::::::.:::............:::.:::::::::::::::::::::::::::::::::::::::::..........::.:::::::::::::::::::...........................................
Address
ta: Date Point of
0: ❑Transportation by:: Shipment
CommonCarrier ..........................................................................................................
Destination
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❑ Disinterment Cemetery A ress
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<i ❑ Reinterment Cemetery Address
Permit Issued to : Registration Number
:> Name of Funeral Firff +l ill iam, J. Burke & Sons
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Address
North Broadway, Saratoga Springs, N.Y. 12866
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Name of Funeral Firm liilakiri :Dispositionr:t .............. .............. ........ ................
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g o o Whom
Remains are Shipped, If Other than Above
PP
Address
Permission Is hereby granted to dispose of the human rein s describprd abo a as indicated.
Date Issued Feb.23,1989 -^
Registrar of Vital Statistics
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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:
51 Date of Disposition a�`a 3 Place of Disposition
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;i (address)
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section, (section) (lot number) (grave number)
i.:: Name of Sexton or Person in Charge of Pre ises
Z: (please print) r�
w Signature Title L�/�� /d'l,� r�Y / J /
DOH-1555(9/86)p 1 of 2(formerly VS-61)