Nappi, James C. Pine View Cemetery a Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME:
-_-_. --E D .S
_-._. ... ._ RETURN TIME; __ _
DATE 3 TIME REMAINS ARRIVED AT CREMATORY 11
NAME OF FUNERAL DIRECTOR OR REGRISTEREO RESIDENT DELIVERING _
_ Ge' FWD
REMAINS:
NAME
--_ _..—CASE A __ _II�•j�..
TYPE OF CONTAINER: l JLL� r-��
PLACE OF DEATH; 117
-------------
ESTIMgTED WEIGHT OF REMAINS 6 CONTAINER_
- �,—
PIACEOINHOLD:
PLACED IN REFRIGERATION: �-'-
-___ _
OgTF OF CREMATION: _ ---
TIME STARTED: __ �p
�' -�D-1_— TIME COMPLETED:
PLACED IN RETORT:
RETORT pIN WHICH REMAINS WERE CREMATED: _ _
DETAILED
REASON AC FOR D LAYDELI IF REMAINS WERE CREMATED MORE THAN AS HOURS
FROM TIME OF ACCEPTED OEIIVERY:
NOTE; THE CR¢mgnOH Lao - — _
SHALL RETAINED IN THE PERMANENT
FILE or THE cnEmA noT r
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Authorization for Cremation and Disposhton
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