Persons, Ian TOWN OF QUEENSBURY
Pine View Cemetery and Cremntorium
21 Qunker Rond, Queensbury, NY. 12804-5902
(518) 745.4476 (518) 745.4477
http://w%vw.queensbury.net
Funeral Director: a(0V-,�.,N-Z-j
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Name of Deceased: _ 1't � R 9,Ea M S
Case Number: 2 �/
Date of Cremation: — Z2 C2
Retort: C-� ����2,
Time Cremation Started: a 2 3 )
Time Cremation Completed: t-
Type of Container: GNA VQ �ZCJ �� +q��\ ��. 2
Remarks:
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