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Bravo, Carlos H. NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Carlos H.Bravo Male Date of Death Age If Veteran of U.S.Armed rdrees, 05/03/2020 61 Years War or Dates H Place of Death Hospital,Institution or WCity,Town or Village Hempstead Town Street Address Mount Sinai South Nassau p Manner of Death © Natural Cause 1:1Accident Homicide Suicide Ej Undetermined Pending W Circumstances Investigation W Medical Certifier Name Title Jonathan Altus MD Address 1 Healthy Way, Hempstead Town,New York 11572 Death Certificate Filed District Number Register Number City,Town or Village Hempstead 2950 Burial Date Cemetery,Crematory or Facility Name El05/11/2020 Pine View Cemetery and Crematorium Entombment Address Cremation Queensbury Hamlet,New York ElDonation ZO El Removal Date Place Removed and/or and/or Held H N Hold Address O Po a Date int of 0 El Transportation Shipment Q by Common Carrier Destination Disinterment Date Cemetery Address Reinterment I Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home N F Walker Inc 01234 Address 2039 Merrick Avenue,Merrick Hamlet, New York 11566 Name of Funeral Firm Making Disposition orto Whom I- Remains are Shipped,If Other than Above 2 Address Q Uj Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/07/2020 Registrar of Vital Statistics Tathfeen 91urray(ECectronicalTy Signed (signature) District Number 2950 Place Hempstead, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ~ T, L W Date of Disposition s tL 110 Place of Disposition � (address) 2 W N (section) (lot number)r ' (grave number) IM _J\ Name of Sexton or Person in Charge of Premises /plea a print/Z W Signature Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) a„a 77�+ Receipt Human remains of delivered on , 20 f Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#