Hammill, Helen A. Pine View Cemetery 8. Crematorium
Quaker Road
Queensbury, NV 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME:
_
OgTE fl TIME REMAINS gftRIVEO AT CREMATORY RETURN TIME:
NAME OF FUNERAL DIRECTOR OR REGRIST
pppp� EREO RESIDENT DELIVERING REMgINS:
NAME. __—
TYPE OF CONTAINER, - _CASE X �(
PLACE OF DEATH: Iy �
ESTIMATED _
WEIGHT OF REMAINS 8 CONTAINER
PLACED IN HOLD:
PLACED IN REFRIGERATION: � _
DATE OP CREMATION.
TIME STARTED: ,__ ii XS�II I!� MECOM LETED, Z.)
PLACED IN RETORT _ (odOn
,I MOVED
RETORT If IN WHICH REMAINS WERE CREMATED:
DETAILED REASON FOR DELAY IF REMAINS WERE CREMgTEO� F
FROM TIME OF ACCEPTED DELIVERY: MORE THAN GS HOURS
NOTE. LNF CR¢mgilOHLOG S MALL 6E RFi ME PERMANENT OF THE c y
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Aufhorlre0on for Cremation and Disposition
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FINAL DISPOSITION
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Authorimbon for Cremation and Disposition
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Roland G Hoag
11636
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