Laserfiche WebLink
PLACE OF BIRTH *P M nt of Commom and Lab, <br />�. 1 eY•4Y O, TN[ C[N•Ya <br />County °f " " " "' STA1411ARD CERTIFICATE OF BIRTE <br />i�) Township of .......... _ $tat* of Nebraska pp�C+ {(gyIIpp <br />t Villep ot------ n/�' - I I R"Istored <br />City L. i .------ st .:............Wud) L.c, <br />FULE NAPE OF CHH.D�I'�'- ^ai.y -s�. }4f�"*?�'r(7t chug ix nor e t .men, maco i <br />Bo. of --- <br />ChIW.. <br />__ <br />' <br />) Ti[. TrIN•A. -.. ' NaerWe la •rMr eta ; Dab of ^ -_ <br />Or orA.rt _ NMrth i t.T birth %!8_.19(a�. <br />(Toth anxwereA only lnevrnt Of Dlural hlrlhB)' /I - (H>�')����(DaY) (Ye•N <br />—__ <br />NAM E <br />/� /p q�•THER <br />"ISJ- .'S"'a- �-t <br />O <br />ynM(Ty�+1FR <br />.N�� <br />-.�I <br />{ <br />RESIDENCE <br />- <br />RESIDENCE <br />COLOR <br />A'OE Af LAST <br />I <br />I COLOR... <br />7 <br />_ <br />-may A�BIAIRBDAY. <br />Il nam) . <br />v <br />BIRTHPLACE <br />�.BIRTRPLACE <br />r],_ <br />I C� <br />OCCUPATION <br />-� <br />i OCCUPATIONS <br />Numberotchildten ipm to mb t <br />_moth r, Inaudlna Dlaeent birth. ... _....� <br />Nembe of Chlirt�no <br />.....:....... ..I tNP mourer now <br />'.- - <br />Ilrhut I. <br />CERTIFICATE OF ATTENOING PHYB <br />C:IAftO <br />I hereby eartily that i attand°d the birth of thlo*104 wbe wu _____._ <br />___--------------- <br />Rom [live or PMI horn <br />�a�d <br />i <br />THIS CERTIFIES TjlE- <br />.ABOVE TO BI!' A TRUE COPY OF AN <br />CERTI1wICATE <br />ORI�`INAL <br />ON VTIA-:,WITlf TILE STATE Di PARTMHNT OF <br />BUREAU OF VITAI ,,T`ATISTICS. W111C11 IS THE LEGAL <br />fit; lI. <br />DEPOS <br />FOR VTTAI RECORDS., <br />TORY <br />� L <br />' ,Ul & {;4P'ON O6 HI At.11{ AN1 S7 ":1 I( Rh:GI�IhAk <br />. I.17NCOLN. NI- BRASKA <br />i <br />1 9" <br />. - <br />�r <br />�a�d <br />