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Sarkar, Rathindra Kumar YORK STATE DEPARTMENT OF HEALTH Burial Transit Permit ,,dreau of Vital Records Name First Middle Last Sex Rathindra Kumar Sarkar Male Date of Death Age If Veteran of U.S.Armed Forces, 05/01/2020 57 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village North Hempstead Town Street Address North Shore University Hospital p Manner of Death © Natural Cause Accident ❑Homicide ❑Suicide ❑Undetermined Pending VCircumstances Investigation W Medical Certifier Name Title G Imran Barlas MD Address 300 Community Dr, North Hempstead Town,New York 11030 Death Certificate Filed District Number Register Number City,Town or Village Manhasset 2951 1155 Burial Date Cemetery,Crematory or Facility Name 05/07/2020 Pine View Crematory Entombment Address 1 Cremation Queensbury,New York Donation zRemoval Date Place Removed 1:1and/or and/or Held H N Hold Address O IL Date Point of to ❑Transportation Shipment p by Common Carrier Destination El Disinterment Date Cemetery Address Reinterment I Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home NEW LEAF CREMATION 02058 Address 3930 LONG BEACH RD., ISLAND PARK,New York 11558 Name of Funeral Firm Making Disposition or to Whom II— Remains are Shipped,If Other than Above Address Q W (L Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/06/2020 Registrar of Vital Statistics Wayne 7fenryWink(E(ectronica((ySiyned) (signature) District Number 2951 Place Manhasset, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: WDate of Disposition S IS(Zb Place of Disposition �n.� ..r IV-- lu (address) W (section) (lot number) (grave number) 8 Name of Sexton or Person in/rge of Premises " ' ImAi l IT /pi se prt/ in W Title Y� Signature DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 013743 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named pn burial nernut Official Funeral Directors Reg.or License#-111