Clough, Ruth Shirley Prneu
ematoriu
243 HANOVF.x STREET,MANC ESTER,NH 03104-4857 (603) 625-5777
57 HIGH STREET, BxA1-1woRO,VT 05301-6749 c•., (802) 254-5655
CERTIFICATE of CREMATION
Cremation ID Number: 114716
This is to certify that the remains of Ruth Shirley Clough, of Epping, NH, who died
on August 9, 2021, were cremated August 12, 2021 at Phaneuf Crematorium , ct. .
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in accordance to its rules, regulations and all legal requirements. c,,
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This further certifies that:
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cam, The identity of the deceased was confirmed prior to cremation. l/ '_' -,
,Th..-, The Cremation Authorization Form was signed by the authorizing agent prior to cremation. ()F A'SLR*
C_, The death certificate was signed and cause of death specified on the certificate prior to cremation.
.c-., The NH medical examiner viewed the deceased prior to cremation,completed and signed the Certificate
By Medical Examiner For Cremation Form NHDOJ-29 and authorized the cremation to take place or
the VT Medical Examiner has authorized the cremation to take place per 18 V.S.A.§5201(b) and signed
the Medical Exa iner's Permit to Cremate form VDH-OCME-CP-01/2011.
c ' The cremate ain were diligently removed from the cremation chamber,carefully processed,and
re those t e pe named above.
Atteru ing , matory Technician
This certificate should accompany the cremated remains to their final destination. See reverse side for important regulations.
CLOUGH
NAME Ruth Shirley Clough Age:
Lot Owner: Shirley Clough
Lot# Algonquin 3 E Grave# 1B
Case: urn
Died: 8. 9.21 Interred: 1 0.9 .21
Funeral Home: Family (Steve Barson)
Cemetery: Pine View