Lohr, Elizabeth �O WN OF QUEEVBU,'kY
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director A
h)EI- 7$ —'7
Name , f Zj /7 ,0 911e _Case #
Date of Cremation o2 " '� — --2�0
Time Cremation Started q1' qS-42f1v1 I
Time Cremation Completed lo,f 10 /M(
Type of Container �f /1✓ ��,1� cZ/VJ,7,
Remarks :
19 IAI
9� �" /9,6
Sent By: Durfee Funeral Hume; 802 265 4256; Feb-6-00 10:41AM; Page 1111
TOWN O OUEENSOURY
PINE VIEWCEMETERY
CREMATORIUM
Quaker Road, Queensbury, Now York,12804
Cernetery 745-444TO
AUTHORIZATION TO CREMATE
The undersigned requestss and authorizes.Pine View Crematorium; in accordance with and subject
to its Rt.Aes an lea uia ons.tio clett+ste ti�ea iria:c�i:
Mrs. E11tZab th. C. Lohr, .
(NAME). (SEX)
157 Her.i to a fE i 1 l Rut.1 and Ve imgpnt : 057 1
(STREET) -: ..(C!'t'Y): (.S'ii ) (ZIP CODE)
wiha.did+err. f t h aey+sf :Fe b r ii Y
ao oa
Vr.
(RACE) (ADORESS)
N00mard address of e at p+srsan�u4ha�x`
r>ee�st buie�r�dstflce#t nam.
,.: RrelAtiq�ahrP W deeeat� ,..Arit�JCH't;EFk___._ ;,
Name o(ru.ner*IHOme,_.R2bs►rtc-Aubt in funeta .r }?Au1tri�V Y, t
IVAPORTANT
ssen#. t tea!:k>�st.a«►t.rnX.k?1'DWIN ge;tlt .:d so ,cu; ;po; *et in;h_*or her.
body, (C1RCt.E ONE). ,
k
t C thillft.l.ht> ,tt t!<Iil for Mafaticm tQ awe 1+dren of the tern and
to,gkaitt thadiap 'l of ti1+e bd'rairt+KMirtit,that ny: i It F�tta ttain+e e�+er beenremoved ar may be destrriye 1,and'agrea'to preateet,d fit!g i tnalroas Whte VOW
ere . nurm eny and an ciainw ond derrlan ds i kn
rl fro ade .
'af 4gif�r lrli as tl�Ce f Whoever
cf.0v.CW ti t d w me qom.Sto,
such cfal a or demands r an* .? Y tu,ntlMese,.f Air:frat►dulent,
ESS) {AID
i+IATUR 0 R LA OR LE EK AND M RESS)
Sipped on this deter,,, (?1r ti Alt
TOWN OF'QUEENEdURY
• PINE VIEW CEMETERY
CREMATORIUM
of "to1;ou"nsbutp, Now YcWk 12$%
Cr�Mry 74d�M178
AUTHMZATION TO C:OB"TE
uruMr�rigrMd rsqus$Ist ii�nd•umoftes Ping view Cnmdwiurn, to acootdwm with and Subject
r Rui...,e1d t4s +�wpr�s:l :ara t+r�..�t►.i ru M t'
Mrs. I
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157 H0 i t'a f H1.1 flu .i and Niormogrt.-Itzol
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a The Ma aF s ;..ai r f:o. v t.
( (A.. )
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Nom a pu.nwal me"�Roair c�.• ti �.0 r Esa�."Aii i�_..
AVOR rAPtr
I r+sprssdt�il�+El;�t�Irt bsl�#�Ir:ltrgRtidgl�th�, .o$q;.�,�.�prvc 1�t.tNr.ar het
body, (CIRCLE ONE)
':�d:dMSat t1lb,''dIMO�NIIItlt�': ';O�rt AhM!M:�1Ct�'�tt�►:_�wi�NM�-'i�t� i�i :�l+� �ir berg
t+lrnorsd or may bs�sfidy�l,'artd b t�prated,d�rr�l; :�f�i�..�ttnw
C * m wly,.W40111-doi a ow de noWs the loss W. to ss:whict:m muds
. '; : '�°�M�trol>.fl�'!+g1159114r�ititl w�.tlatl.:�t;lR,.�!�:� (�n14�ina:ay;.'dirscla�,'..whAtlwr
37
(SW4ATURE OF REURTIVE OR
such a or drrtasr�ds sr+i r#,�irlyoN�•Enoacdi�es.-t�e►;e�d�:f�liA�uMrt:. .
L .E AN DtWol S)
Sipied w this dift:r,,r,&r ,
. - No.
STATE OF VERMONT _.
EXAMINER'S PERMIT TO CREMATE A DEAD HUMAN BODY
Full name of decedent Mrs . Elizabeth C. Loh r
Decedent's address 157 Her i tage Hi 1 1 , Rutland, Vermont 05701
Date of dead, Feb. 6. 2000 Place- of dcatlt 157 Heritage Hi 1 1 . Rutland, VT 05701
Cause of death certified by Dr . Peter S t i ckney
Permission to cremate the body of this decedent at P i ne V i ew Cr ema t o r y
Quaker Road, Queensbury, New York 12084
(Numr and addr"r of Crematory)
has been requested by — 1 ame s C Aub i n of Roberts- Au h i n Fu n e r a 1 Home
(Fusieral Dirr4•lor)
Vermont F. D.
License F. 1030 266 Allen Ave. , Pou1 tney, Vermont 05764
(Addreso of Funeral Director)
Being sufficiently informed as to the causes and circumstances of the death of the above
described decedent, permission is hereby granted to cremate the body at; requested.
Date �'�` �/ a� (Signed) `�'� , Examiner
Address
18 VSA SEC 5201 M