Salas-Almachi, Patrucuo NEW YORK CITY THE CITY OF NEW YORK—DEPARTMENT OF HEALTH AND MENTAL HYGIENE
DEPARTMENT OF HEALTH OFFICE OF VITAL RECORDS
AND MENTAL HYGIENE PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS
April 27,2020 07:25 AM 156-20-036282
EVENT:(CHECK ONLY ONE) ®DEATH ❑SPONTANEOUS-TERMINATION ❑INDUCED TERMINATION CERTIFICATE NUMBER
NAME First,Middle,Last AGE SEX DATE MONTH DAY YEAR
OF (YYYY)
Patricio Salas-almachi 73 Male EVENT 04 23 2020
BOROUGH NAME OF HOSPITAL OR INSTITUTION OR STREET ADDRESS
PLACE OF NEW PORK CITY
EVENT Manhattan The Mount Sinai Hospital
NAME OF PHYSICIAN OR MEDICAL EXAMINER'S NUMBER CREMATION APPROVED BY:
OF ME/MLI
CERTIFIER METHOD ❑ INTERMENT CREMATION MaureenF Obrien
Sara Phillips DISPOSAL ❑ OTHER M.E.CASE# M20024041
PLACE OF NAME OF CEMETERY OR CREMATORY(OR DESTINATION) CITY OR COUNTY AND STATE DATE r05
DAY YEAR
OF (YYYY)
DISPOSITION Pine View Crematory Queensbury,New York DISPOSITION 01 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 Frank J.Barone Funeral Home 1 4502 Avenue D Brooklyn NY 00609
APPLICANT NAME OF N.Y.STATE LICENSED FUNERAL DIRECTOR(PRINT) S ATU J J J( N.Y.STATE LIC.#
Christopher Doria i na a eclronicallyAuthenticted
(7�//�' a 10987
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, • •s� ,`��� G� � Qil� ,�`
interlined or altered in any manner.: Cry Registrar °-
VR21(REV.7/09) FEE PAID$ 40.00 DATE 04 / 26 /2020 '00' SON By_Service Evital
MM DD YYYY 4ryOFN
Public Health Law Sec. 4145(2b)
013679 4
Receipt
Human remains of = delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#