Schoen, Grace Z6
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Grace Schoen Female
Date of Death Age If Veteran of U.S.Armed Forces,
01/05/2021 57 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital
al
p Manner of Death X❑Natural Cause ❑Accident 0 Homicide ❑Suicide ❑Undetermined 0 Pending
UCircumstances Investigation
Ui Medical Certifier Name Title
CI Rodney Ying MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 12
❑Burial Date Cemetery,Crematory or Facility Name
01/07/2021 Pine View Crematory
Entombment Address
X❑Cremation Queensbury Town,New York
❑Donation
Z Removal Date Place Removed
and/or and/or Held
F- Hold Address
N
0
n- Date Point of
N ❑Transportation
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
1— 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 01/07/2021 Registrar of Vital Statistics join Pauf ranckgketronical61 4inea9
(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:
F- L�W Date of Disposition )/g 171 Place of Disposition I„„( Of 4,4.--_
2 (address)
W
Cl)CC (section) i (iot number) (grave number)
gName of Sexton or Person in Charge of P e ises4r.hoLt�'�1
Z / (ple e print) �+
W Signature �%'� Title / P'al' }rl
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) 014392
Receipt
Human remains of delivered on ! , 20
.t
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#