Winslow, Leroy TOWN OF Q5BJR91
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director 3 Few( r
Name 1-er(;1 (1J4n � � Case # 5)),
Date of Cremation
Time Cremation Started LUG-5 PM
Time Cremation Completed 3. 30 -PM .
Type of Container Cc, -ctL ,ret 30Col CAS-C C,r,..s u rof
Remarks :
4: 14 P
�calCL. t/t. 1 = 3O 44