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STATE OF NEBRASKA
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<br /> ,. WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTME�N7' QF �LTH Al�lt� �
<br />HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF TH��K3�6�1�1,44•RECd� I.�
<br />FILE WT!'H THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVI�ES;-:IY.jTA�;R��-0� ;: ',+� .
<br />OFFICE, WHICH IS THE LEGAL DEPOSIi"ORY FOR VITAL RECORDS �,' .,!
<br />ee in J�
<br />DATE OF ISSUANCE a � ! � ' � C � �
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<br />N�BRASKA LINCOLN MORTH PLATTE IIC A10 TABOR 691
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<br />.JOHN HIRAM STILL LAURA MARGARET
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<br />�'} "�"` RICHARD PIONTKOWSKI
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<br />B�A APRIL 3,1992 GRAND ISLAND CITY CEM
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<br />MARCH 31.1992
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