Current, William H. NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit rmit
Bureau of Vital Records
Name First Middle Last Sex
William H.Current Male
Date of Death Age If Veteran of U.S.Armed Forces,
12/09/2020 91 Years War or Dates 1949-1951
Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Wesley Health Care Center Inc
11.1
p Manner of Death a Natural Cause Accident ❑Homicide ❑Suicide El Undetermined El Pending
C.) Circumstances Investigation alMedical Certifier Name Title
Pamela Casey NP
Address
131 Lawrence St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 640
Burial Date Cemetery,Crematory or Facility Name
12/10/2020 Pine View Crematory
❑Entombment Address
X❑Cremation Queensbury Town,New York
Donation
Date Place Removed
Removal and/or Held
— and/or
- Hold Address
0
Date Point of
Cl) ❑Transportation Shipment
p by Common
Carrier Destination
Date Cemetery Address
Disinterment
El 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
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/10/2020 Registrar of Vital Statistics Join cPauf ranckglectronicaQ 4714
(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 )l Ili to Place of Disposition L d✓
W (address)
W
CC CC (section) (lot number) _ (grave number)
Name of Sexton or Person in Charge of Pre ' es 4 tt')� �t 4{(i
ta . (plea print)
lL Signature �S Title CRC"
DOH-15551o7/18)p t of 2
Public Health Law Sec. 4145(2b) 014 390
Receipt
Human remains of —delivered on , 20
1
Pine View Cemetery Representing the funeral home named n burial permit
Official Funeral Directors Reg.or License#