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�� �� �Isc��A��aUS R�coR� v � 29088-TNLAU6YSTINEC0.6RANDISLANO,NEBR. . � � ' � � � - � CERTIFICATE OF DEATH �� NEHRASKA (STATE) DEPARTMENT OF HEALTH Division of Vital S�atistias STANDARD CERTIFICATE OF DEATH DEPARTMENT OF COMr�IERCE BUREAU OF THE CENSUS Social Security No. . . . . . . . . State File No. 3�06 1. PLACE OF DEATHs (a) County Hall (b) City or town Grand Island (c) Name o�' hospital or institu�ion: St. Francis (d) Len�th oP stay: Tn hospital or institution 5 d�ya In this commun�ty 7 years 2. USUAL RESIDENCE OF DECEASED: (a) S�ate Nebr�,ska (b) Coun�y Hall ( c) City or town Grand Island (d) Street No. 1923 Wst. Koenig L-000 ( e) If Por eign born, how long in U.S.A� 34 years. 3 (a� FULL NAME Wi111am Lee 3 (b) If veteran, na,me war. . . . . . . . . . . . . ��. Sex M 5. Color or race W - 6. (a) Single, widowed, married, divorced M 6 (b) Name of husband or wife Frances May Hayes 6 (c3} Age oP husband or wife iP alive 54 7. H3rth date oP deceased Nov. 24, 1P�90 �, �. AGE: 55 Years 4 Mon�ha 14 Days IY less than one da�. . . .hr. . . . . . .min. 9. Birthplaee Presten, La.ncashire, England 10. Usual occupation Railroad Car Foreman 11. Tnduetry or busines€� Railroading Father i2. Name Thomas Lee 13. Hirthplace England Mo�her ��. Maid�n name E11en Panford 15. Birthplace England 16. (a) Informant ' s own signature Mrs.Helen Townsend (b) Address (3-rand Island, Nebr. 17. (a) Burial (b) Date thereof 4-12-�Fi (e) Place: burial or cremation arand Island, Nebr. 1�. (a) Signature of funeral director Livingston-3ondermann (b) Addreas �+06 Wst. Koenig, G. I. Nebr. 19. (a) Date received local registrar �x 15 1946 (b) Registrar� s signature F. 3. White MEDICAL CERTIFICATION 20. Date of death: Month A�ri1 day � 1946 12 hour 10 minute M. 21. I hereby certify that I at�ended the deceaaed from 4 March, 1946, to � April, 1946; that I last saw him alive on � April, 7.946; an d that death occurred on the date and hour stated above. Immediate cause of death Hypostani Pneumonia Duration 3 da. Aue to Underline the caus� �o Careinoma Left Lun 6 Mo. which death e3�ould be t er con i ions charged etatlsticallyt (Include pregnancy within 3 months oP death) PHYSIQIAN M�.,�or findingst OP operations � 4f autopay 22. I�' death was due �o external causes, filliin the following: (a) Accident, auicide, or homie3de (speoify) - (b) Date of occurence ( c) Where did in,jury occur: (d) Did in,jur�r occur in or about home, on Parm, in industrial place, in public place: Whi1e �,'� work. (�) Means of in�jury 23. Signature Frank D. Ryder (M.D. ) Addreea Grand Isl�nd, Nebr Date si�ned 9 Apr �6 047D 25. I hereby certiPy I personally embalmed the body of the deceased named hereon. Jamea D. Livingston License No. 1�35 THIS CERTIFIES THE ABOVE TO BE A TRUE COPY OF AN ORIGINAL CERTIFICATE ON FILE WITH THE STATE DEPARTMENT OF HEALTH� HiTREAU OF VITAL STATTSTICS, WHICH IS THE LEGAL DEPO5ITORY FOR VITAL RECORDS. ��p� �g� W. S. Petty. M.D. DIRECTOR OF HEALTH AND STATE REGISTRAR LINCOLN, NEBRASKA Ma.y 17 19�F� Fi1ed Por record this 7 day of October 194�, at 4 o 'clock P.M. - �/�� �; � e�i�ster�D ds 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-o-o-�o_o=o_o-o_o-o_ .:o ORDER IN THE GOUAT�Y COURT OF HALL �OtTR1TY, NEBRASKA IN� THE MATTER OF ) ) ORDER - LeRoy E. McBAIN ) � Thia matter eoming on to be heard thia 2nd day oP O�tober, 19�8, on the applicsation oP the eaid LeRoy E. MeBain, whiah application was approved by Margare� P. �IcBain, his wife; and beir�g fully advised in the premis�s - THE COURT FINDS that '�h� condition of �h� eaid LeRoy E. McBait�� s health has been ' improved materially by mor� tem��erate habit8, tha'� his Judgmen� and ability have been improved for the sam� reason, that it now apP�ars to the Caurt �hat �h� reason for �he oonserva�orship has nox been remo�red.