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Robert- Allen, Particia Ann NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Patricia Ann Allen-Roberts Female Date of Death Age If Veteran of U.S.Armed Forces, 02/07/2024 81 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Saratoga Springs Street Address Wesley Health Care Center Inc p Manner of Death ZI Natural Cause Accident ❑Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title 0 Andrea Guthorn NP Address 131 Lawrence St,Saratoga Springs,New York 12866 Death Certificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 83 Burial Date Cemetery,Crematory or Facility Name 02/09/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation Removal Date Place Removed - and/or and/or Held - Hold Address 0 a Date Point of (/)OTransportation p by Common Shipment Carrier Destination O Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above Address CC ILL' O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/08/2024 Registrar of Vital Statistics cDifTon Shoran(ECectronica1ty 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: l— -�W Date of Disposition /O U,7 y Place of Disposition �"i,J e j/'eJ Cr-ern � 2 (address) W N CC (section) (lytnu r) (grave number) , G Name of Sexton or Person in Charge of Premises i-VNN,-D Z (please print) W Signature Title PTf+ DOH-1555(07/i8)p i of 2 k d 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#