Hinkson, Elbert C. 33
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Elbert C Hinkson Male
Date of Death Age If Veteran of U.S.Armed Forces,
01/07/2021 99 Years War or Dates 1943-1946
Place of Death Hospital,Institution or
WCity,Town or Village Granville Town Street Address Slate Valley Center for Rehabilitation and Nursing
p Manner of Death El Natural Cause 1=1 Accident Homicide ❑Suicide Undetermined Pending
W Circumstances Investigation
U
0 Medical Certifier Name Title
Carl Beckler MD
Address
10421 State Route 40,Granville Town,New York 12832
Death Certificate Filed District Number Register Number
City,Town or Village Granville 5756 1
ElBurial Date Cemetery,Crematory or Facility Name
01/08/2021 Pine View Crematory
11 Entombment Address
X❑Cremation Queensbury Town,New York
❑Donation
0 Removal Date Place Removed
and/or and/or Held
N Hold Address
0
d Date Point of
U) ❑Transportation
p by Common Shipment
Carrier Destination
ElDisinterment 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
Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/08/2021 Registrar of Vital Statistics ,7ennyLitrd, Marta&(!YectronicallySlgned)
(signature)
District Number 5756 Place Granville, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition / 9 aL/ Place of Disposition �;,,le tM Crz j--,r—i_c
.iaawess)
W
CC (section) '/ (lot number) (grave number)
0 Name of Sexton or Person in Charge of Premi s af/iffe�n E- Li ve
Z (please print)
W Signature Title
DOH-1555(07/18)p t of 2
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License# -