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<br /> DEPARTMENT OF _i E,1LTH III
<br /> �li biriaoo of Vital Statistics
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<br /> j1 rt.1.t...r ue ce.t.. ST:1N D,1RD CERTIF►CA 1E OF DEATH r.e.+.x<._--'_
<br /> t 1 1 STATE OF M1F.P.RASI:A
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<br /> THIgeBRT IES�-THE ABOVE O BE A TRUE COPY OF AN ORIGINAL
<br /> CER1'TFICA pN FILE NJjTH HE STATE DEPARTMENT OF HEALTH,
<br /> BURE1 A VITAL S'I�ATIt'1-CS, WHICH IS THE LEGAL DEPOSITORY
<br /> FOR v I., CORDS. •-'1 _ - J
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<br /> \ 'BIR GT'aR OF" ITAL S ATI TICS AND ASSISTANT STATE REGISTRAR I
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<br /> I `�`"""tiNCOLN, NEBRASKA —
<br /> Issuo A 0., m'nt•r 3fi, I":,,
<br /> Te/%2i'<5 5%y X3.2- //-/O
<br /> 3824
<br /> DEATH CERTIFICATE
<br /> State of Nebr.,:Dept. of Health
<br /> to
<br /> Mitchell K. Dean,
<br /> State of Nebraska 1
<br /> County of Hall s as
<br /> Entered on Numerical Index and filed
<br /> for record in Office of Register of
<br /> Needs on the 29 _� of
<br /> ovember 19 at_
<br /> o'clock and 'D minutes_ A:M.
<br /> and riled in Book _ __ _ _ of
<br /> �Misee __ P --at
<br /> Regis
<br /> Fees •
<br /> � � o �.60 .... .
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<br /> .777
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