Nadal, Christina NEW YORK CITY THE CITY OF NEW PORK-DEPARTMENT OF HEALTH AND MENTAL HYGIENE J v
DEPARTMENT OF HEALTH OFFICE OF VITAL RECORDS
AND MENTAL HYGIENE PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS
April 18,2020 04:54 PM
156-20-030321
EVENT:(CHECK ONLY ONE) ®DEATH ❑SPONTANEOUS TERMINATION ❑INDUCED TERMINATION -------------C RTI-"IC ---"""""---------------------
CERTIFICATE NUMBER
NAME First,Middle,Last AGE SEX DATE MONTH DAY YEAR
OF (YYYY)
Christina Nadal 65 Female EVENT 04 18 2020
PLACE OF BOROUGH NAME OF HOSPITAL OR INSTITUTION OR STREET ADDRESS
EVENT NEW YORK CITY
Bronx 3890 Sedgwick Ave,Apt 1 F, Bronx, NY 10463-4440
NAME OF PHYSICIAN OR MEDICAL EXAMINER'S NUMBER METHOD ❑ INTERMENT CREMATION APPROVED BY:
CERTIFIER OF CREMATION ME/MLI Jeremy Stuelpnagel
Benjamin E Criss DISPOSAL ❑ OTHER M.E.CASE# B20020029
PLACE OF NAME OF CEMETERY OR CREMATORY(OR DESTINATION) CITY OR COUNTY AND STATE DATE MONTH DAY YEAR
(YYYY)
DISPOSITION OF
Pineview Crematory Queensbury, New York DISPOSITION 05 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 Schuyler Hill Funeral Home 3535 E Tremont Ave Bronx NY 01559
APPLICANT NAME OF N.Y.STATE LICENSED FUNERAL DIRECTOR(PRINT) S NATURE ��,J N.Y.STATE LIC.#
Jeannine Carbone e�1,�?P at4u? 're Electronically Authenticated 10534
PERMISSION IS HEREBY GRANTED TO DISPOSE OF THE RE QUESTED ABOVE.
NOTICE: This permit is not valid without the seal of the Department a�!�•••�•i
of Health and Mental Hygiene;or if it has been corrected, • Y lo/4—
interlined or altered in an �• •
y manner. 09 Cly Registrar
VR21(REV.7/09) FEE PAID$40.00 DATE 04 / 29 /2020 001 , • 0• By_Service Evital
MM DD YYYY 4�OF t
Christina Nadal
Schuyler Hill Funeral Home
TR050120_FH06/C09/052
Public Health Law Sec. 4145(2b)
Receipt
Human remains of y delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#