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<br /> CERTIFICATE: !
<br /> (COPY) ,�
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<br /> CERTIFICATE OF HEALTH State of Nebra$ka ;;
<br /> Charles VG. Bryan, Governor
<br /> Department of health and welfare
<br /> Division of vital statistic� �'�
<br /> 1 Place of Death ;;
<br /> County Hall State of Nebraska
<br />� � City Burkett �� ��
<br /> 2 Full Name;�atilda Richter ��'
<br /> Residence Burkett, Nebraska ;;
<br /> Personal and Statistical particulars ��
<br />, ' 3 sex 4 8olor or �ace 5 Single, Married, �Pidowed, or Div�rced j;
<br /> Female �Phite �Pidowed '�
<br /> 5a If Married, �tidowed, or Divorced '�'
<br /> Husband of August Riehter i�
<br /> ' 6 Date of Birth (Month, da.y, and year) "
<br />! April 3 ,��35 �;
<br /> 7 Age Years �anths Days - �'
<br /> �o No 5 f
<br /> � Occupation of Deceased ''
<br /> (a) Trade,profession, or particular kind of work ��
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<br />� � Housewife � �i
<br /> ';9 Birthplace Germany �!
<br /> ' 10 Name of father Ernest Voight ;':
<br /> 11 Birthplaee of Father Germany i;
<br /> 12 Maiden name of mother Agnes Otto '
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<br /> 1� Birthplace of �dother Germany ii
<br /> 1 Informant P�rs. Alexander Graham, Doniphan, Nebr. ;;
<br /> 15 ��z�d-.�— ig�— : ��
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<br /> Re�istrar ��
<br /> �edical �ertificate of Death �'
<br />` �'16 Date of Death April �th 1925
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<br /> ';17 I hereny certify, That I attended deceased from May, 192�, to April �th, 1925 that I last ��
<br /> saw her alive on April 7th, 1925 and that death occured, on the date stated above, at 2 A. B���
<br /> The cause of death was a$ followa: Organic Heart Desiar ��
<br /> Contributory Secondary ;
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<br /> Di an 0 e ti n Precede Death o
<br /> a Id i:
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<br /> �Pas There an Autopsyp No �i
<br /> �Phat Test Confirmed Diagnosis? Clinic
<br /> (Si�ned) V�illis J. Raynor, M. D.
<br /> Burkett, Nebraska ;
<br /> ���19 Place of Burial, Cremation, or Removal !�
<br /> Doniphan, Nebr. !'
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<br />' ' Date of Burial r
<br /> April 10,1925 ' '
<br />� 20 Undertaker J. A. Livingston Address Grand Isla,nd
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<br /> Filed for record on the 1� day of April 1925, at 2 o� clock P. M. ��I
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<br /> Register o Dee s ��i
<br /> -O-O-O-O-O-O-O-O�.Q-O-O-O-O-O-O-O-O-O-O-O-O-O-O-O-O-O-O-O_O-O-O-O-O-O-O-O-O-O-O--O-O-O-fl-O-O-O- i;
<br /> ' ASSIGN�rIENT OF LEASE "
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<br /> October lst,1923. i'
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<br />' FGR VALUE RECE D d in h n d B1 in Horse ule and Cattle Commission Com an the �'
<br /> IVE ,an �. d pai a ,�I P Y, i
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<br /> ' lessee and party of the second part in the agreement and lease entered into on the first ;;
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<br /> ' day of 4ctober ,1923 ,bp and betv�een the Bradstreet & Clemens Company,a corpoxation and Blain ��
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<br /> '' Horse,�llule and �attle Commission Company,a corporation,hereby sells ,assigns ,tra.nsfers and ��
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<br /> conveys the said lease to the Commercial State Bank,of Grand Island,Nebraska,as collateral h
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<br /> security for any and all indebtedness now existing or which may hereafter exist ,includin� �
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<br /> '; �11 the renewals ancl extensions of said indebtedness for the period during �vhich said indebt—�
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<br /> � edness shall exist of Blain Horse,��2ule and Cattle Commission Company. Said Commereial State �j
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<br /> � Bank in the event of default in the payment of said indebtedness,or any part thereof,whether I�
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<br /> ; of principal or interest ,shall have the power to sell this lea.se at public or private sale �
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<br /> upon giv�ng the said Blain Horse,�dule and Cattle Commission Company twenty days notice in �i
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<br /> ' writin b re ist r d .n il of t u o inten ion o xercis the
<br /> e e a he sa,i.d defa lt and f i ts t t e e rnrtrer
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<br /> ' of sale. In the event said lease is sold at public sale,the Commercial State Bank is hereby
<br /> �j granted the right and power to bid for and purchase said lease in its o�vn name and behalf. ,
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<br /> � BLAIN HURSE ,?VIULE & CATTLE CO�d?�'ISSION CO�PANY j
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<br /> (CORP) By �'Y. I. Blain �
<br /> ' ( SEAL) President �I
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<br />� �� Attest:
<br /> '� John Bachman Secretary.
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<br /> Filed far record_this 1�_ da�=of A�ril_1925�_at ,��4___'_^ ___'__ _ __
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<br /> I ' Register o ee s !
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