Balley, Robert C:) -.A TOWN OF QUEENSBURY
Pixie View Cemetery and Crematorium
21 Quaker Road, Queenshury, NY. 12804.5902
(518) 745-4476 (518) 745.4477
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Funeral Director:
Name of Deceased: l � f3sl
Case Number:
Date of Cremation:
Retort:
Time Cremation Started: )�) •�
Time Cremation Completed:
Type of Container: C- V 2\1-yj g 1
Remarks:
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