Suprenant, Louis M Pine View Cemetery g Crematorium
Quaker Road
Queensbury, NY 12004
(510) 745-4477 or (510) 745-4476
LUNERAL NOME: _-CIM N -- _ - RETURN TIME:
DATE b TIME REMAINS ARRIVED AT CREMATORY: i1 LLID
NAME OF FUNERAL DIRECTOR OR RECRISTEREO RESIDENT DELIVER REMAINS-
---
NAME: _ [D✓lam. _SURI REYf((], _
CASEX
TYPE OF CONTAINED: � ro(7
PLACE OF DEATH: FORT P
FO I'
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ESTIMATED WEIGHT OF REMAINS 8 CONTAINER II _
PLACED IN HOLD. _ uo --'s+--
153
PLACED IN REFRIGERATION;
DATE OF CREMATION; "-
--.._ --
TIME STARTED: IE QS Pn
— TIME COMPLETED.
PLACED IN RETORT: 100 Qp -"'—'
� MOVED $pp J YOp1y1 RETORTM IN WryICH REMgINS WERE CREMATED;
DETAILED REASON FOR DELAY IF REMAINS WENS CREMATED MORE T a8 HOURS iSQh
FROM TIME OF ACCEPTED DELIVERY:
NOTE., THE CneMATIONLOG _ . .. -_
[L o[ neTARNED tN THE v[xmnNex{ FILE OF THE CREMATORY,
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