Towne, Milo Magnus NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Milo Magnus Towne Male
Date of Death Age If Veteran of U.S. Armed Forces,
02 / 27 / 2021 16 Fetus War or Dates N/A
}- Place of Death Hospital, Institution or
WCity, Town or Village Saratoga Springs Street Address Saratoga Hospital
Q Manner of Death®Natural Cause 0 Accident E Homicide 0 Suicide �Undetermined 0 Pending
lii
Circumstances Investigation
tL Medical Certifier Name Title
0 Eliot Birnbaum MD
Address
59 Myrtle St # 100, Saratoga Springs, NY 12866
Death Certificate Filed District Number Register Number
Vi City, Town or Village Saratoga Springs 0 \
giii InBurial Date Cemetery or Crematory
03 / 05 / 2021 Pine View Crematory
0 Entombment Address
?;ECremation Queensbury, NY
Date Place Removed
a?❑Removal and/or Held
and/or Address
Hold
Date Point of
Transportation Shipment
by Common Destination
Carrier
ii$p3 Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care 00364
01 Address
402 Maple Ave., Saratoga Sp., NY 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
ffi
Permission is h re y granted to dispose of the human remai scrib d abov as indicated.
`i' Date Issued 3 5 202 t Registrar of Vital Statistics
(signature)
District Number Lf5o I Place Saratoga Springs , New York
,;` I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
to
tit Date of Disposition 3 Igi Zi Place of Disposition five-.a (i :,II__
dress)
fit
N
CC (section) (IA number) (grave number)
0 Name of Sexton or Person in Ch a of Premi / /t``' L- -�+�'•-��
Z (pleasent) •
Signature Title enw " t
(over)
DOH-1555 (02/2004)
Public Health Law Sec. 4145(2b) 014616
Receipt
Human remains of ` '' ' • delivered on , 20
x.
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#