Ponusky, Robert A Pine View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME: t1L at.Z RETURN TIME:
DATE & TIME REMAINS ARRIVED AT CREMATORY: (I I 14/l( I( 041
NAME OF FUNERAL DIRECTOR OR REGRISTERED RESIDENT DELIVERING REMAINS:
antf
NAME: 1208 r000KI.f CASE # / 11
TYPE OF CONTAINER: «O.41 t fc, Ca it/a304 d ( (K{.(Iw('
PLACE OF DEATH: amf CS((S (06ri+c
ESTIMATED WEIGHT OF REMAINS & CONTAINER f`SO Ws / ZCC/`6-
PLACED IN HOLD:
PLACED IN REFRIGERATION: I1;(6PY1
DATE OF CREMATION: II MO
TIME STARTED: 12)4M TIME COMPLETED: 2 La f rl
PLACED IN RETORT: IZ 50Q1 MOVED: 130pli
RETORT# IN WHICH REMAINS WERE CREMATED: S t p f fowei flAK 601
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 48 HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE: THE CREMATION LOG SHALL BE RETAINED IN THE PERMANENT FILE OF THE CREMATORY.
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