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Bilodeau, Pauline B NEW YORK STATE DEPART tCy DEPARTMENT Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Pauline B.Bilodeau Female Ole of Death Age If Veteran of U.S.Armed Forces, 05/26/2023 95 Years War or Dates t` . Place of Death Hospital,Institution or 7'441 Z City,Town or Village Y g Saratoga Springs Street Address Saratoga Hospital Manner of Death Ej Natural Cause Accident E Homicide Suicide Undetermined aPending Circumstances Investigation W Medical Certifier Name Title Cl Catherine Dawson MD ' ' Address 211 Church,�St,Saratoga Springs,New York 12866 Death COiificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 302 Burial Date Cemetery,Crematory or Facility Name 05/30/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York ODonation Removal Date Place Removed •,_ 11, and/or Held 'ail* a '''Hold' Address 0 "' sportation Common Date Point of Shipment arrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Brewer Funeral Home Inc 00211 Address 24 Church Street PO Box 500,Lake Luzerne,New York 12846 Name of Funeral Firm Making Disposition or to Whom -. Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/30/2023 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: W Date of Disposition 5- 31 113 Place of Disposition k1J 2 (address) W U) CC (section) 4 (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises Z l lease print/ r W Signature 0C2 Title [1(Li/► 44L(o' DOH-1555(07/18)p 1 of 2 0 17004 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#