Arpei, Virginia K. NEWYORKSTATEDEPARTMENTOFHEALTH -- Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Virginia K.Arpei Female
Date of Death Age If Veteran of U.S.Armed Forces, •
11/24/2020 82 Years War or Dates
Place of Death Hospital,Institution or
Z_City,Town or Village Saratoga Springs Street Address 7 Martin Avenue,Saratoga Springs,New York 12866
pManner of Death 0 Natural Cause Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending
W Circumstances Investigation
U
W Medical Certifier Name Title
CI Susan Muller MD
Address
510 Geyser Road,Ballston Spa Village,New York 12020
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 604
❑Burial Date Cemetery,Crematory or Facility Name
11/25/2020 Pine View Crematory
❑Entombment Address
X❑Cremation Queensbury Town,New York
❑Donation
❑Removal Date Place Removed
and/or and/or Held
H Hold Address
0
Q. Date Point of
Cl) ❑Transportation Shipment
p by Common
Carrier Destination
❑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
5 Address
CC
W
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 11/25/2020 Registrar of Vital Statistics 9vltn Pau19ratckgketrottca**flei9
(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:
Z Date of Disposition #-J,k2!> Place of Disposition —Pi.n1c' cu1 C/evat.K (
111 (addr o?
W
(section) (lot num en) (grave number)
Name of Sexton or Person in Cha a of Premis
(please print)
Z J
W 1`l �`� Title 0 3
Signature T
DOH-1555(07/18)p t of 2
Public Health Law Sec. 4145(2b) 014236
Receipt
Human remains of delivered on , 20_
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#