Alexander, David Charles NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
David Charles Alexander Male
Date of Death Age If Veteran of U.S.Armed Forces,
12/23/2020 77 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital
LIJ
p Manner of Death 0 Natural Cause ❑Accident El Homicide ❑Suicide Undetermined Pending
CCircumstances Investigation
LU Medical Certifier Name Title
Sarah Paris MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 679
❑Burial Date Cemetery,Crematory or Facility Name
12/24/2020 Pine View Crematory
ID Entombment Address
0 Cremation Queensbury Town,New York
❑Donation
Z Removal Date Place Removed
and/or and/or Held
~N Hold Address
0
d Date Point of
NL j Transportation
Eh Common Shipment
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
j— 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 12/24/2020 Registrar of Vital Statistics join rPau1Franckg ctronically4rg74
(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 / -„?1-2e9eU Place of Disposition Pt doev. £„J C/�
K142 W
2 (address)
W
CC
CC (section) (lot number/ )j (grave number)
Name of Sexton or Person in Charge f Premises /�101"
(please print)
W Signature �L �� ,1-/ Title Q/� �
DOH-1555(07/18)p i of 2 U
� r
Public Health Law Sec. 4145(2b) 014339
Receipt
Human remains of r ' ! delivered on , 20 ,
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#