Loading...
Alvarez, Maria del carmen NEW YORK CITY THE CITY OF NEW YORK-DEPARTMENT OAEALTH AND MENTAL HYGIENE I DEPARTMENT OF HEALTH OFFICE OF VITAL RECORDS AND MENTAL HYGIENE April 17,2020 09:54 AM PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS 156-20-029061 EVENT:(CHECK ONLY ONE) X DEATH ❑SPONTANEOUS TERMINATION ❑INDUCED TERMINATION CERTIFICATE NUMBER NAME First,Middle,Last AGE SEX DATE MONTH DAY YEAR (YYYY) Maria del Carmen Alvarez 68 Female EVE rr 04 07 2020 PLACE OF BOROUGH NAME OF HOSPITAL OR INSTITUTION OR STREET ADDRESS EVENT NEW PORK CITY Queens Elmhurst Hospital Center CERTIFIER \ NAME OF PHYSIC METHOD ❑ INTERMENT X CREMATION IAN OR MEDICAL EXAMINER'S NUMBER CREMATION APPROVED BY: OF MFJMLI AngelaL Capellupo, Sowmya Kalava DISPOSAL ❑ OTHER M.E.CASE#Q2001 7749 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 % OVERNING 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 © gg��ao � a 13073 PERMISSION IS HEREBY GRANTED TO DISPOSE OF THE RE _ UESTED ABOVE. / NOTICE: This permit is not valid without the seal of the Department �::l��of Health and Mental Hygiene;or if it has been corrected, interlined or altered in any manner. i' � Cry Registrar VR 21(REV.7/09) FEE PAID$40.00 DATE 04 % 13 /2020 %•� �: By Service E_vital MM DD YYYYOF Cyn. N,;'l Twilad_ Public Health Law Sec. 4145(2b) 013608 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#