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� �� <br /> I�IISCELI���NEOUS RECORD V <br /> 2a088—THE AUGUSTINE C0.GRAND ISLIIND,NEBR. � <br /> TONKON MILLINERY COMPANY <br /> (CORP) By I. Edward Tonkon <br /> (SEAL) resi en <br /> Attest Gor don Holeomb <br /> ecre ary <br /> STATE OF TEXAS ) <br /> ) SS. <br /> COUNTY OF DA1.�1�AS ) <br /> Subscribed and sworn to bePore me this 26th day of December, 19�+6. <br /> Frances Neilstead <br /> ( SEAL) Notary Public <br /> Commission ex:�ire� June 1, 1947. <br /> Filed for record this 21 d�,y of Februa.ry 1947 at 9:00 0 ' elock A. l�. �-�-t-� N <br /> � egister o�eec�s <br /> -�-0-0-0-0-0-0-�-0-�-0-�-J-0-0-�?-�:-0-0-0-0-0-0-J-0-0-0-0-0^-�-�-0-0-�-0-0-0-0-0-0-0-0-0-0 <br /> CERTIFICATE OF DEATH AND AF'FIDAVIT <br /> NEBRASKA (STATE) DEPARTMENT OF HEALTH <br /> Divis�.on oP Vi�al Statis�Gics <br /> STATNI7ARD CERTSFICATE OF DEATH <br /> I DEPARTMENT OF COMMERCE <br /> BUREAU OF THE CENSU3 Social Security No. None State File No. R 6702 <br /> 1. PLACE OF DEATHt <br /> (a) Coun�y Hall <br /> (b) City or town Grand Island, Nebraska <br /> c) Name of hospi�al or institution St. Francis Hospital <br /> d) Length of stay; In hospital or ir��titution About � da.ys <br /> In this community - - - - - <br /> 2. USUAL RESIDENCE 0�' DECEASED: � <br /> (a) State Nebraska <br /> (b) County Howard <br /> (c� City or town St. Paul, Nebraska <br /> (d Street No. ,5th Street <br /> (e) If foreign born, how long in U.S.A.? - - - - - years <br /> 3 (a) FULL NAME Anna Gertrude Steinbach <br /> 3 '. (b) If veteran, <br />� <br /> name war None <br /> 4. Sex- Female <br />, 5. Co�or or race- White <br /> 6 (a Single, widowed, married, divorced- Widowed <br /> 6 (b� R1ame of husband or wife - John Steinbach <br /> 6 (c) Age of husband or wif e, if alive - - - - - y�ars <br /> 7. Birth date of deceased August 25, 1865 <br /> 8. AGE <br /> Years 79 Months 11 I3ays 5 <br /> If less �han one day - - - - - hr.: • - - - - min. <br /> 9. Birthplace New Haven, Indlana <br /> 10. Usual occupation Housewife <br /> 11. Indue�ry or busin�ss Homemak3ng <br /> FAT�IEFFt . _ ,._: <br /> 12. Na.me Firat unknown, Baker <br /> 13. Birthplace Unknown <br /> M02HER <br /> 1�. Maiden name Bernandi�� Martin <br /> 15. Birthplace Lima, Ohio <br /> 16. <br /> (a) Informant� s os,rn signature Mrs. John Smith <br /> (b) Address St. Libory, Nebraska <br /> 17. <br /> (a) Burial <br /> (b) Date thereof 8-1-45 <br /> (c) Place; burial or cremation St. Libory Cemetery <br /> 18. - <br /> (a) Signature of funeral director Keating Mor��a�y <br /> (b) Address S�.Paul, Nebraska <br /> 19. <br /> (a} Jul. 31, 19�5 <br /> (b) F. S. White <br />'� <br />