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STATE OF NEBRASKA
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<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF' THE NEBRASKA DEPARTMEIV�`UF H��LTl�;1�IYL�
<br />HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORICs�,'Z�IAC. ��'aR2��OlV1 � i'':
<br />FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND KUMAN SERVICES�;;6/I�/�L.y p+��
<br />OFFICE, WHICH IS THE LEGAt DEPOSITORY FOR VITAL RECORDS., d";� ,� �� .;-. 's'� ��, �'
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