Dutra, Elsie Alice Town of Queensbury
Certification of Cremation
s4 � Pine View Cemetery and Crematory
This certifies that the remains of: Elsie Alice Dutra
were cremated on November , 29 20 12 at the Pine View
(Month) (Day)
Crematorium, Queensbury,New York, and these are the cremated remains of said body.
Date of Death November , 28 20 12 Age 85
(Month) (Day)
Funeral Home Singleton Sullivan Potter Registered No. 625
Zi#
(Authorized Signature)
DUTRA
NAME Elsie Alice Dutra Age: 85
Lot Owner: Ron & Danielle Gilligan
Lot# Mohican 60 E Grave# 5
Case: Urn
Died:1 1 /2 8/2 0 21 Interred: /2 3/2 0 21
Funeral Home: Singleton Sullivan Potter
Cemetery: Pine View