Thompson, Bruce L O 4N OF QUEEVBU—r�Y
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director
Name Case #
Date of Cremation gM jd
Time Cremation Started ' 7'
Time Cremation Completed " v v
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Type of Container 2'K �'( Q_
Remarks :
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Town of Queensbury
Pine View Ce n*tmy and CremsWum
21 Quaker Road,Que ensbury, New York, 12MA
Cemetery Offlce: (518)7454476, Crematorium:(518)745.4477
A Rttorizabon io Cremate
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who died on 13 day of )q` �- 20 01'
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Signed on d*date:
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I herleby died Pk*View Carnetor M to ASPOW of the,rxee NDW remains 99 tckmw.
MON to
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tf puivetoftn of t=renamed MMekrs la r WOWAod,dbK*two
Reviskor AprN 18,2007