Cohen, Doris D. Pine View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-414/�77 or (518) 745-4476
FUNERAL HOME: IfLL') RETURN TIME:
DATE S TIME REMAINS ARRIVED AT CREMATORY: -1114I LO /0 bAn
NAME OF FUNERAL DIRECTOR OR REORISTERED RESIDENT DELIVERING REMAINS: -
NAME: IAW %0(IEN CASE ((S 8
/
TYPE OF CONTAINER: L ( Ou
H
PLACE OF DEATH; _ Z D S (4 PE $.iuRORJ QEj EA1
ESTIMATED WEIGHT OF REMAINS A, CONTAINER /CC
PLACED IN HOLD:
PLACED IN REFRIOERATION:
DATE OF CREMATION: _ 71 13 i 1D
TIME STARTED: Il 46 h TIME COMPLETED: G Sf 1
PLACED IN RETORT: kS) ATI MOVED: R>OFYI
RETORT k IN WHICH REMAINS WERE CREMATED:
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN GS HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE, HE CREMATION LOG SMALL BE RETAINED THE PERMANENT FILE OF THE CREMATORY.
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