Greaves, Renee NEW YORK CITY THE CITY OF NEW YORR'=DEPARTMENT OF HEALTH AND MENTAL HYGIENE '541—
DEPARTMENT OF HEALTH OFFICE OF VITAL RECORDS
AND MENTAL HYGIENE PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS
April 14, 2020 11:04 AM 156-20-026028
EVENT:(CHECK ONLY ONE) ®DEATH ❑SPONTANEOUS TERMINATION ❑INDUCED TERMINATION -------------
NAME First,Middle,Last AGE SEX DATE MONTH DAY Y YYR)
OF
Renee Greaves 67 1 Female I EVENT 04 09 2020
PLACE OF BOROUGH NAME OF HOSPITAL OR INSTITUTION OR STREET ADDRESS
EVENT NEW PORK CITY
Queens Elmhurst Hospital Center
CERTIFIER
NAME OF PHYSICIAN OR MEDICAL EXAMINER'S NUMBER METHOD O INTERMENT CREMATION
CREMATION APPROVED BY:
�
OF ME/MLI Jelena Krcedinac
Jennifer Pintiliano-Gemmo DISPOSAL O OTHER M.E.CASE# Q20016786
PLACE OF NAME OF CEMETERY OR CREMATORY(OR DESTINATION) CITY OR COUNTY AND STATE DATE MONTH DAY YEAR
DISPOSITION OF (YYYY)
Pineview Crematorium Queensbury, New York DISPOSITION 05 07 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.
NAME OF ESTABLISHMENT ADDRESS M-rc'oklyn
ND STATE N.Y.STATE REG.#
FUNERAL
ESTABLISHMENT Hood Funeral Services Inc. 2601 Pitkin Ave NY 02064
APPLICANT NAME OF N.Y.STATE LICENSED FUNERAL DIRECTOR(PRINT) SIGNATURE N.Y.STATE LIC.#
Kenneth Hood EI yAjjvmtjmted 11651
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, • $`'.• Y Q��
interlined or altered in any manner.: Cry Registrar
VR 21(REV.7/09) FEE PAID$ 40.00 DATE 04 / 12 /2020 %•� . •:' By_Service_Evital
MM DO YYYY 4rya!Nt*
Public Health Law Sec. 4145(2b) Q 13 7 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#