Bauer, Marilyn # 113
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First 1111LMi '0" Last Sex
Marilyn Bauer Female
Date of Death Age If Veteran of U.S.Armed Forces,
03/12/2021 74 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Saratoga Springs Street Address Saratoga Hospital
IL al Manner of Death ❑X Natural Cause ElAccident El Homicide ❑Suicide EiUndetermined 11 Pending
I
Circumstances Investigation
W Medical Certifier Name Title
CI Hung Nguyen MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District N er Register Number
City,Town or Village Saratoga Springs 4501 201
❑Burial Date Cemete Crematory or Facility Name
03/15/2021 Pine Vie rematory
ElEntombment Address
O Cremation Queensbury Town,New York
❑Donation
0 ❑Removal Date Place Removed
and/or and/or Held
F- Hold Address
0
d 1-1 Dale Point of
(q ❑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
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 03/15/2021 Registrar of Vital Statistics join Pail rFranck(Ekctronicall:y Signed
(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:
W~ l
Date of Disposition .311)1/,' Place of Disposition ` G�
2 (address)
W
CC CC (section) �(t number) (grave number)
Name of Sexton or Person in Charge of Premises ^'
Z (pleaseF int) y
W vot
Signature TitlekiOC
DOH-1555(07/18)p t of 2
Public Health Law Sec. 4145(2b , J1,..4 / .vi.
. ,.:
Receipt
t i , , ,
Human remains of , delivered on , 20
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Pine View Cemetery Representing the funeral home named viturial)pormit 1
Official Funeral Directors Reg.or License# ' '-1,
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