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Last modified
4/12/2012 11:21:24 AM
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4/5/2012 2:26:50 PM
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002-207
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• �'i + <br />R� •_ 4 "It'll�I_ <br />THIS CEkt x TO BE A TRUE COPY OF AN ORIGINAL <br />CTrRTIEIC� EL. TH THE STATE DEPARTMENT OF HEALTH, <br />BUREAU OF ViPArgTATISTICS, WHICH IS THE LEGAL DEPOSITORY <br />FOR VITAL RECORDS. <br />/l�i.�_. <br />DIRECTOR OF ITAL S ATI TICS AND ASSISTANT STATE REGISTRAR <br />�s <br />LINCOLN, NEBRASKA.. <br />i <br />i <br />+l <br />co <br />0 <br />m <br />z. <br />0-0 <br />to <br />d - a <br />a .0 .4 <br />�+ <br />ivi-F ' w ti <br />x 0 <br />-d e � , � 00 ; <br />to <br />'� 0/ <br />
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