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Wilkinson, Elizabeth NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Elizabeth A. Wilkinson Female Date of Death Age If Veteran of U.S. Armed Forces, Dec. 6 1997 89 War or Dates ------------ .. Place of Death Hospital, Institution or City, Town or Village City of Saratoga Sr. Street Address Saratoga Hospital Manner of Death 0 Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined El Pending Circumstances Investigation Medical Certifier Name Title Andri ' Baran M.D. Address 69 Caroline St. Saratoga S rin<s NY 12866 Death Certificate Filed District Number Sa Register,N11mber City, Town or Village City of Sarato a SD. Date Cemetery or Crematory ❑Burial Dec. 8, 1997 Pineview Crematorium Address ©Cremation Queensbury, New York FDate Place Removed ❑Removal and/or Held �.. and/or Address > Hold Q Date Point of ❑Transportation Shipment ifl by Common . Destination Carrier ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address <[ Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home, Inc. 00525 >< Address 7 Sherman Ave. , Corinth, New York, 12822 Name of Funeral Firm.Making Disposition or to.Whom Remains are Shipped, If Other than Above Address 41 Permission is hereby granted to dispose of the human rem in s d s ed abov sin icated. Date Issued Registrar of Vital Statistics (signature) s€ District Number '� � Z Place I certify that the remains of the decedeni identified above were awposed of i co r ance with this permit on: LU Date of Disposition 1 Place of Disposition (address) LU >E (section) lot number) (grave number) GName of Sexton or Person in Charge of Pr mises g °'(please print) r-T Signature Title ,� �� DOH-1555 (10/89) p. 1 of 2 VS-61