Morrow, Valerie NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Valerie Morrow Female
Date of Death Age If Veteran of U.S.Armed Forces,
12/23/2020 69 Years War or Dates
Place of Death Hospital,Institution or
W City,Town or Village Saratoga Springs Street Address 47 Regatta View,Saratoga Springs,New York 12866
p Manner of Death ❑X Natural Cause 0 Accident ElHomicide ❑Suicide �Undetermined ❑Pending
IJJ
✓ Circumstances Investigation
W Medical Certifier Name Title
O Gloria Ethier DO
Address
11 Hampstead Place 103,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 675
❑Burial Date Cemetery,Crematory or Facility Name
12/23/2020 Pine View Crematory
❑Entombment Address
X❑Cremation Queensbury Town,New York
❑Donation
ZO Removal Date Place Removed
▪ and/or and/or Held
N Hold Address
0
U) ❑Transportation
Date Point of
p by 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
Remains are Shipped,If Other than Above
Address
CC
W
C' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/23/2020 Registrar of Vital Statistics join Pauf rank ctronica(Srgneo9
(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:
1— / ;/� /�
Z Date of Disposition 7 ;2o,4j Place of Disposition .5 e
2 (address)
W /
N
CC (sea/on) )(tot number) ( (grave number)
• Name of Sexton or Person in Char of Prem. s �Y/ylV �d �� W Cl/
Z lle�ase print)
W •
Signature !I% Title v`V"'�
DOH-1555(o7/18)p i of 2
Public Health Law Sec. 4145(2b) — r + 011336
Receipt
Human remains of 4 delivered on , 20 fi
i
Pine-View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#