Aquino, Ofelia 4/ IUD
NEW YORK CITY THE CITY OF NEW YORK—DEPARTMENT OF HEALTH AND MENTAL HYGIENE
DEPARTMENT OF HEALTH OFFICE OF VITAL RECORDS
AND MENTAL HYGIENE
April 16,2020 03:59 PM PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS
156-20-028451 _
EVENT:(CHECK ONLY ONE) X DEATH ❑SPONTANEOUS TERMINATION ❑INDUCED TERMINATION CERTIFICATE NUMBER
NAME First,Middle,Last AGE I SEX DATE MONTH DAY YEAR
OF (YYYY)
Ofelia Aquino 92 Female EVT EN 04 11 2020
PLACE OF BOROUGH NAME OF HOSPITAL OR INSTITUTION OR STREET ADDRESS
EVENT NEW PORK CITY
Queens Elmhurst Hospital Center
CERTIFIER
NAME OF PHYSICIAN OR MEDICAL EXAMINER'S NUMBER METHOD ❑ INTERMENT X CREMATION CREMATION APPROVED BY:
OF ME/MLI Ian Bautista
Joseph Lieber DISPOSAL ❑ OTHER M.E.CASE#Q20019208
PLACE OF NAME OF CEMETERY OR CREMATORY(OR DESTINATION) CITY OR COUNTY AND STATE DATE MONTH DAY YEAR
(YYYY)
DISPOSITION Pineview Crematory Queensbury, New York DISPOSITION 104 18 2020
THE CERTIFICATE OF DEATH HAVING BEEN FILED AS REQUIRED BY THE HEALTH CODE,AND ALL LAWS AND REGULATIONS
GOVERNING THE PREPARATION AND DISPOSAL OF HUMAN REMAINS HAVING BEEN COMPLIED WITH, PERMISSION IS
HEREBY REQUESTED TO DISPOSE OF THE REMAINS AS IDENTIFIED ABOVE.
FUNERAL NAME OF ESTABLISHMENT ADDRESS - CITY AND STATE N.Y.STATE REG.#
ESTABLISHMENT Gerard J. Neufeld, Inc. 8804 43rd Ave Elmhurst NY 00661
APPLICANT NAME OF N.Y.STATE LICENSED FUNERAL DIRECTOR(PRINT) EfZf�
TURE N.Y.STATE LIC.#
OmarJ. Rodriguez 13073
Sgalue Elatlrmically Aulnenticelg0
PERMISSION IS HEREBY GRANTED TO DISPOSE OF THE RE QUESTED ABOVE.
NOTICE: This permit is not valid without the seal of the Department ' •:,:��
of Health and Mental Hygiene;or if it has been corrected, :'
interlined or altered in any manner. Cry Registrar
VR 21(REV.7/09) FEE PAID$40.00 DATE 04 16 (2020 •0 0• * By Service Evital
MM DD YYYY CY)y go..�
i
Public Health Law Sec. 4145(2bj _ CJ 13 6 0 4
Receipt
i
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A -
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#