Krupit, Barbara Joan )7r
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Barbara Joan Krupit Female
Date of Death Age If Veteran of U.S.Armed Forces,
01/31/2021 90 Years War or Dates
F.. Place of Death Hospital,Institution or
W City,Town or Village Wilton Town Street Address 60 Waller Road,Wilton Town,New York 12831
p Manner of Death ❑X Natural Cause El Accident ❑Homicide ❑Suicide El Undetermined El Pending
W Circumstances Investigation
W Medical Certifier Name Title
CI Madison Zuis NP
Address
9 Carey Road,Queensbury Town,New York 12804
Death Certificate Filed District Number Register Number
City,Town or Village Gansevoort 4569 7
ElBurial Date Cemetery,Crematory or Facility Name
02/01/2021 Pine View Crematory
❑Entombment Address
0 Cremation Queensbury Town,New York
❑Donation
ZO Removal Date Place Removed
and/or and/or Held
H Hold Address
0
d Date Point of
co 11 Transportation Shipment
p by Common
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
EC
W
EL Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/01/2021 Registrar of Vital Statistics Susan Bafrfwin(Ekctronicall:y Signed)
(signature)
District Number 4569 Place Gansevoort, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
IH
W Date of Disposition Z 13121 Place of Disposition .�IL d(�
address)
W
CC CC (section) (lot number) (grave number)
g Name of Sexton or Person in Charge of Pre ises is /�MA4Ii
1 �-
Z (p(e e print?
W �� � =—� Title `Yit�'H l"v[
Signature
DOH-1555(o7/18)p i of 2
Public Health Law Sec. 4145(2b) i; 014491.
Receipt
Human remains of ' delivered on , 20
"
,,. / „ j '
Pine View Cemetery kepresenting the funeral home named on burial permit
Official Funeral Directors Reg.or License# .