French, Ruth TORN OF QUEEVBU9 Y
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSHURY, NEW YORK 12804
(518) 745-4475 (518) 745-4477
Funeral Director
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Name Case # T7
Date of Cremation '/ / — /6
Time Cremation Started ':�/4r �
Time Cremation Completed / // �/ &I I
Type o f C o n t a i n e r G'��',1� jagn Z2 NO 0/c !/7",,---,o9y
Remarks :
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T 'TOWN OF QOEENSBURY "M
PINE VIEW CEMETERY
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CREMATORIUM ejlq
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Quaker Road, Queensbury, New York 12801
Phone (518) Crematorium 798-4726 or if no answer Cemetery 793-9777
AUTHORIZATION TO CREMATE
The undersigned requests and authorizes Pine View Crematorium, in accordance with and subject to its
Rules and Regulations to cremate the remains of:
_ Ruth French Female
(Name) ' (Sex)
(Street) City) (State) (Zip Code)
who died on j�� I 1 day of l99�j
at 3
(Place) (Address)
Name and address of nearest living relative or name of person authorizing cremation:
Irving E. French
(Name) I Adcl ess)
Relationship to the deceased Husband
Name of funeral home Tossing Funeral Home
IMPORTANT:
I represent that to the best of my knowledge,the deceased has or has no pacemaker in his or er ody.
(CIRCLE ONE)
I certify that I have the full power and authorization to arrange for the cremation of the remains and
to direct the disposition of the cremated remains, that any personal possessions have either been removed
or may be destroyed, and agree to protect, defend and save harmless Pine View Crematorium, from any and
all claims and demands for loss or damages which may be made against them by reason of, or connected
with the cremation of said remains as directed, whether such claims or demands are, or are not, wnolly
groundless, false or fraudulent.
fitness) (Signature of Relative or Legal Rep.)
��14X_ 15 Pj,,"
(Address) (Addr
Signed on this date