Radtke, Geogia G. NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Georgia G.Radtke Female
Date of Death Age If Veteran of U.S.Armed Forces,
11/20/2020 95 Years War or Dates
F.. Place of Death Hospital,Institution or
WCity,Town or Village Saratoga Springs Street Address Wesley Health Care Center Inc
p Manner of Death ❑e Natural Cause ❑Accident ❑Homicide Ei Suicide El Undetermined Pending
Circumstances Investigation
W Medical Certifier Name Title
Diane Westbrook NP
Address
131 Lawrence St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 589
ElBurial Date Cemetery,Crematory or Facility Name
11/20/2020 Pine view Crematory
ElEntombment Address
X❑Cremation Queensbury Town,New York
❑Donation
ZO ❑Removal Date Place Removed
- and/or and/or Held
N Hold Address
0
d Date Point of
N ❑Transportation Shipment
p by Common
Carrier Destination
El Disinterment
Date Cemetery Address
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
I— Remains are Shipped,If Other than Above
Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 11/20/2020 Registrar of Vital Statistics Join PaulFranck(Elearonrcalljc*ne4
(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- /
Z Date of Disposition J/Z/-Zo4p Place of Disposition 1-n,,'Je J e�.v t-Gyhh-ip r
2 (addre
W
CC
CC (section) (lot n mber). (grave number)
ci Name of Sexton or Person in Char of Premise !-'71�0�� L '�
(please print)
W Signature Title n ey-#04 t`
DOH-1555(o7/18)p t of 2
Public Health Law Sec. 4145(2b) 01 4 21 c
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#