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Biswas, Gouranga NEWYORKCRY THE CITY OF NEWYORK-DEPAW EMOF HEALTH AND MENTAL.HYGIENE IM DEPARTMENT OF HEALTH OFME OF VITAL RECORDS AND MENTAL HYGIENE PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS May 15.2DZ002:07 PM 1513-20-044959 EVENT:OCHEIX ONLY ONE) $IDEATI ❑SPOWMN STERMWAWON OINOUCEDTERMINATON NAME FRUMWNr ListxEAY wm AR GCuran BbweS 38 MGb 05 12 MO PLACE of NEW YORILCT' eOPo16N ^"'EorxosPmuoww.mi ONMBmEU. xEM Queens Lan Iateenci iSh MadimiC r cERTINER w.uEaE.xncPnaawoiutExwrvwaNv oi.hwa»T D[cwNAi �Kari MINING ImrwIB SmM rose QmIMa Y l e.,0200<4398 PYCEOf mcaErtnroaoaN�IdvMuseu oncwrvl'iuoaTert DISPOSRNIN xraE pirreNew Crem ,.aa Ouwnsbury, NV0i H 05 16 W20 HE CENTIFFEAFTE EFF,DEATH BROWN ALM F�U AS REQUIRED BY THE HEALTH GOADE,AND ALL LAVE AND REAGA-ki GOVERNING WE PREPARATION AND DAWAi OF HUMAN REMAINS MPULED WITH PEAMOSION IS HEREBY REQUESTED TO DISPOSED TF7HE MEMBERS ME DENTIETTED ABOVE EMEVABLw m REFS HAVING BEEN wPly"mite anrtuo.A FUNERAL ESTAaLIBXMEM New Leaf CramatlOn 3%0 La Beach RG Ii Park NY 02(55 APPLICANT . A MEAnx.N,.rt nmw ucN .nrvenoR x IEx"Ic e rm 116105E el oll PERMISSION IS HEREBY GRANTED TO DIBPoSE DE THE PE UESIED ABOVE. �Y�� 111 a;R.I NOTICE: ThE permOiE rot AiIM.JMIn the wal of lire Dewxmam t o114eXH andMi Hygiene:or 00 an been mrrecMO, i3H mtan mMlnaa or a 111 melw nr. y` ur AC91S�f$ vexr NEv.RAW) FEE PAID A RUM DATE 5 13 /2020 ! u By SeNIMEVitHI As � M Public Health Law Sec. 4145(26) 013841 Receipt Human remains of delivered on_. 20_ Re^rea ae eNe Nneua home namM°^ a °i Wua Nrt Yww hE�cmY Fo seal die rsRcc�.cr Liren 1i official