Sweet, John William NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
John Wiliam Sweet Male
Date of Death Age If Veteran of U.S.Armed Forces,
08/19/2022 93 Years War or Dates 1947-1953
�., Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital
Manner of Death Natural Cause ❑Accident Homicide DSuicide ❑Undetermined Frending
UCircumstances Investigation
QW Medical Certifier Name Title
Qiong Wang MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed City Of Saratoga Springs District Number Register Number
City,Town or Village 4501 499
Burial Date Cemetery,Crematory or Facility Name
^- 08/23/2022 Pine View Crematory
Entombment Address
MCremation Queensbury Town,New York
Donation
0 Removal Date Place Removed
and/or and/or Held
Hold Address
0
if#❑Transportation
Date Point of
G by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077
Address
123 Main St,Argyle,New York 12809
Name of Funeral Firm Making Disposition or to Whom
I-. Remains are Shipped,If Other than Above
Address
w
IL Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 08/22/2022 Registrar of Vital Statistics (Dillon Moran(ECectronica1TySigned)
(signature)
District Number 4501 Place City Of Saratoga Springs
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
r Date of Disposition - >-22Z Z.. Place of Disposition �e rr- '143
(address)
W
Q (section) (/otn tuber/ (grave number)
Name of Sexton or Person in Charge o remiss ► )/hfll
(please print)
W Signature s Title O 0 -f,e-a‘/,—
DOH-1555(07/18)p i of 2
' Public Health Law Sec. 4145(2b)
Receipt
Human remains of ` delivered on , 20
Pine Vie Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#. {