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Patel, Manjulaben 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 17,2020 06:09 PM PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS 156-20-029638 EVENT:(CHECK ONLY ONE) )9 DEATH ❑SPONTANEOUS TERMINATION ❑INDUCED TERMINATION CERTIFICATE NUMBER NAME First,Middle,Last AGE I SEX I DATE MONTH DAY YEAR OF Man'ulaben Patel 83 Female EVENT 104 13 2020 BOROUGH NAME OF HOSPITAL OR INSTITUTION OR STREET ADDRESS PLACE OF NEW PORK CITY EVENT Bronx Kings Harbor Multicare Center NAME OF PHYSICIAN OR MEDICAL EXAMINER'S NUMBER CERTIFIER METHOD ❑ INTERMENT X CREMATION CREMATION APPROVED BY: OF ME/MLI KelIV Mouer Louis Allan Kaplan DISPOSAL ❑ OTHER M.E.CASE#B2001 9634 PLACE OF NAME OF CEMETERY OR CREMATORY(OR DESTINATION) CITY OR COUNTY AND STATE DATE MONTH DAY YEAR DISPOSITION OF 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) SIGNATURE N.Y.STATE LIC.# Omar J. Rodriguez © S9 MVeElecir—IlyAVher AWd 13073 PERMISSION IS HEREBY GRANTED TO DISPOSE OF THE RE _ UESTED 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. i Cry Registrar • •? VR 21(REV.gyros) FEE PAID$40.00 DATE 04 ) 14 )2020 ' •• • By Service Evital MM DD YYYY OFN TROL 1$20JN ko /045 Public Health Law Sec. 4145(2b) 01. 35 i k, Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#