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<br /> CERTIFICATE OF DEATH
<br /> State of Nebraska
<br /> Department of Public �elfare
<br /> �ureau of Heatk� .
<br /> Division of vital statistics
<br /> 1 F2ace of Death
<br /> County Hall State Nebr�ska Registered No. . . . . . . . . . . .
<br /> To�+rnship '�ood River � or Village �1ood River. . . . . . . . . . or
<br /> City. . . . . . . . . . . No. . . . . . St. ,"6axd
<br /> Full �Tame Mrs Jane Ftounds
<br /> ( a) Residen�e.No. . . . . . St. , V��.rd. . . . .
<br /> (Usua]. place of abode)
<br /> Length of residence in city or to�n where death occured: yrs. mos.
<br /> How 1 =ng in U. S. ,if of f_oreign birth
<br /> PERSONAL AND STATISTICAL PARTICULAR ��EDICAL CERTIFICATE OF DEATH
<br /> 3 Sex Color cr Race 5 Si�gle ,married � � DATE OF DEATH month,d.ay,and year
<br /> Female yyhit� widowed,or nivo�.� Febr � 1�26 _
<br /> ced (��rite the 17 I HERFBY CERTIFY,That I attended deceased
<br /> '*�ord) from . . . . ,19. . . ,to Feb 5 ,1�26 that I last
<br /> �'ido�aer 'sa�r� h. , alive on Feb 5,1926. and that death
<br /> a I ':��farried';"?i o�ae�',�r ^ivo�'c�d � sband occurred,on the date stated above,at. . . . . �.
<br /> of or '�ife of The CAUSE 0�' DEATH was �,s follows:
<br /> Dated of Birth I�onth,d�.y and year , 3enile Asthemia a efl:���
<br /> Sent 2 -1� 1 (dur�.tion � . . . yrs. . . mo s. . . . . ds. . . .
<br /> � Age Years �donths Days If Leas th�.n 1 day, CON`TRIBUTU.�tY. . . . . . . . . . . . . . . . . . . . .
<br /> �- 4 � hxs for �iin. ( Secondary)
<br /> Occupa.tion of deceased . . . . . .,. . . ( durat ior.) . . . . . yrs. . . . . . r�us. . . . . 4�s
<br /> ( a) Trade,profession ,or I� �lhere �as Disease Contr�.et�d if Not at Pla�e of
<br /> partic�alar ,kind of rt**or'� �ouse Keeper d.eath
<br /> (b) General nature of indus�ry Did a.n Opera.tion Precede Death . Dated of. . . .
<br /> bu�iness,or esta'�lishment in "��s there an Ai�'��p�y. . . . . . . .
<br /> �hich Employed (or employer) ;'�h��Test confirmed dia�nosis
<br /> c I�Ta:ne of e� lo er ( Si �ned) A. T.Hubbell , a�. n.
<br /> ;� Birthplace City or tovQn Febr 6 ,1�2� (Addxess} ''�'ood River Nebr.
<br /> state or countrv) Er�land 19 Place of Burial,Cremation,or Removal
<br /> lONa.:r.e of Father ;7ob Ba::�litt �'ood River Dated of Burial
<br /> 11 Birthplace or �'ather City or to�vn Feb � �926
<br /> State or country) En�land 20 �inder�aker
<br /> 12 �aiden name of mother A. Joblin Evans & son A�.dress
<br /> 13 Birthplace of �o��er City or to�vn �Vood River
<br /> State or countr En�land
<br /> 1 Informant `dGill R�unds
<br /> (A�Bress� '�ood River
<br /> 15 Filed. . . . . . la. . . . . . . .
<br /> . . . . . . . . . . . . . . . . . ,
<br /> Re istrar
<br /> File� for recoxd this 26 day of February 1926,a.t 2 0' clock P. I�.
<br /> _ ��-���
<br /> egister of Deeds
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<br /> AF. I DAVIT I
<br /> Sta.te of Nebra.ska � `
<br /> ss
<br /> Hall County D. L. C�Kane and Kit Baker bein� first duly sworn upon oath uepos� and
<br /> say that they are eng�ged in th� real estate business in �ood River,Hall County,Nebraska,+ha�
<br /> �hey cl�,im an interest in �.nd to the North East Quarter of Seetion 12 Township 10 Range 12 ��st
<br /> �
<br /> � 6�h P, b�.Hall County Nebraska,under and by virtue of a contr2ct and agreement entered �nto by '
<br /> and betraeen said. affiants and Charley Hosher and Dora Hosher,husband and wife,�rherein and
<br /> v�hez°�by they have agr�ed �o sell said premises,and wherein and �vhereby
<br /> � - said Charley and. Dora Hosher,o�mers therQof,agreed and_ agree to pay sa,id affiants a
<br /> � commi�sion of ��f� on the first one thousand and 2�°f� on the balance of the selling price of
<br /> �
<br /> said real estate,o'�tained from any purchaser thereof.
<br /> D. D. OKane
<br /> � Kit Baker
<br /> ' � Subscri'bed and sworn t� before me this 26th day of February 1926. �
<br /> {SE AL) �Jm Suhr
<br /> No�ary Public,
<br /> I�y coms�ission expires Feb 9,1g27
<br /> �� Filed for record this 27 day of February 2g26,at �: 15 0� clock A. I�. _ %q— � p
<br /> . ��C�C�%� �.-C��l�r �.
<br /> egister of eeds
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