Blum, Sandra H105.111 REV 4/08 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH
VITAL RECORDS
RECORD FOR INTERMENT OF CREMATED REMAINS
Full Name of Decedent: Sandra A. Blum
Sex Female Race White Age 73 Cause of Death B Cell Lymphoma
Place of Death Phoenixville-Chester Date of Death Mar 25.2017
Township,Borough,or City—County
Name and Address Campbell-Ennis-Klotzbach Funeral Home, Inc.
Of Person to Whom 610 South Main Street
Remains are Given or Sent Phoenixville, PA 19460
Name of Crematory Phoenixville Crematory, Inc.
Address of Crematory 610 South Main Street, Phoenixville, PA 19460
3/27/2017
Date of Cremation Signature of Cr atory
This record will be completed by a crematory official in all cases where cremated remains are to be interred in a cemetery.
It will be attached in an envelope to the outside of the receptacle containing the remains,but inside the shipping wrapper,
If any,and will be retained by the cemetery as part of its records.
Phoenixville Crematory, Inc.
Hereby certifies that on 3/27/2017 , there was cremated,
according to law, the remains of
Sandra A. Blum
Age: 73 Date of Death: Mar 25,2017
The cremation was at the request of Campbell-Ennis-Klotzbach Funeral Home,Inc.
Who duly identified the body as that of the above name decedent,
and these are the cremated remains.
In witness whereof this certificate has been duly executed.
Case Number: 17-063 Authorized Signature: ��