Ryan, Edward Michael �J
Pine View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME:
REQUESTED RETURN TIME:
NAME OF FUNERAL DIRECTOR OR REGRISTERED RESIDENT DELIVERING REMAINS:
s Ell
NAME: (1 u i�1"�I G h ��/d� J CASE # A/ —
DATE OF CREMATION:
TIME STARTED: TIME COMPLETED:
TYPE OF CONTAINER: �v r r C�Sk -
PLACED IN RETORT: MOVED:
PLACE OF DEATH: J ,F,_,,d/J���ty✓l
ESTIMATED WEIGHT OF REMAINS AND CONTAINER: )bs _
DATE S TIME REMAINS ARRIVED AT CREMETORY:
PLACED IN HOLD:
PLACED IN REFRIGERATION: 9f
RETORT # IN WHICH REMAINS WERE CREMETED: - P4k ff
DETAILED REASON FOR DELAY IF'REMAINS WERE CREMATED MORE THAN 48 HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE: THE CREMATION LOG SHALL BE RETAINED IN THE PERMANENT FILE OF THE CREMATORY.
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