Easchenko, Peter Pine View Cemetery g Crematorium
Quaker Road
Queensbury, NY 12004
(518) 745-4477 or (510) 745-4476
FUNERAL HIME: ,.
__R , t) £ - - RETURN TIME
OATF B TIME REMAINS ARRIVED AT CREMATORY:
NAME OF FUNERAL DIRECTOR OR pEGNISTER[O RESIDENT DELIVERING
REMAINS..
NAME _ ,fll Geen
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TYPE OF CONTAINER: CHSEN wfl.(S ( •
PLACE OF DEgTM
ESTIMATED WEIGHT OF REMAINS 6 CONTAINER y
PLACED IN HOLD: _ � '—Lz-y
PLACED IN REFRIGERATION:
DATE OF CREMATION: �-----
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TIME STARTED: 7:0*
-. --. 1 L —TIME COMPLETED;
PLACED IN RETORT (yy
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RETORT # IN WHICH REMAINS WERE CREMATED:
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 48 HOURS
FROM TIME OF ACCEPTED DELIVERY
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