Biitting, Lisa LF -)do
NEW YORK STATE DEPARTMENT OF HEAllkl,. Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Lisa Biittig Female
Date of Death Age If Veteran of U.S.Armed Forces,
09/17/2022 64 Years War or Dates
l-. Place of Death Hospital,Institution or
W City,Town or Village Saratoga Springs Street Address Saratoga Hospital
Q Manner of Death I1 Natural Cause Accident l l Homicide ESuicide ❑Undetermined ❑Pending
W Circumstances Investigation
U
W Medical Certifier Name Title
Q Santosh Vaghela 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 550
▪Burial Date Cemetery,Crematory or Facility Name
09/19/2022 Pine View Crematory
IllEntombment Address
Cremation Queensbury Town,New York
▪Donation
• Removal Date Place Removed
and/or and/or Held
H Hold Address
0
d Date Point of
U)❑Transportation
p by Common Shipment
Carrier Destination
Date Cemetery Address
IIIDisinterment
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Miller Funeral Home 01199
Address
6357 Nys Rte#30,Indian Lake,New York 12842
Name of Funeral Firm Making Disposition or to Whom
1— 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 09/19/2022 Registrar of Vital Statistics Dillon Moran(Electronically Signed)
(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:
WDate of Disposition g1ZOIlZ Place of Disposition -
(address)
W
CC
N (section) 1 (lot number) (grave number)
O Name of Sexton or Person in Charge of Pre it OWN/ r" S �
(plea print)
W Signature � Title ft',m14
DOH-1555(07/18)p 1 of 2
162 4 ID
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# �-
- ,