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t <br />1, <br />( i <br />�1 <br />) <br />Y L. <br />A <br />PHS- : ReY. -, I NTITE OF NEBRASKA <br />. <br />DEPART ENT DF V-11C HE. —TH. DEPARTMENT OF HEALTH <br />EDVC.ATIUN AND WELFARE BD> ga OI �'IW Statl.tirs <br />BIRTH NO. 126._..._ CERTIFICATE OF DEATH ST.TE FILE No <br />L. PLACE OF DEATH _. USUAI. RFSIDENI I. I Wh.•n J.ren..d Ii+,J. If tutlon: rcriJenre <br />.. COUNTY Adams e. STATE b. CUPS I.dme .Jm(rrbnl. <br />-- Nebraska T�,all <br />b. CITY (It wnide co P 4 Ilmin "it, Hu-0 1. E N C T It OF ., "TV 'It --11 aorWrata limn:...sits RURAL) <br />O Ingleside( ra TOR rYA. 21das T M Grand.Is]an3 mo <br />d. FULL NAME <br />OF If — In h 41 or m• 1 I utee re J 5IRF.IT - <br />HOSPITAL OR .dd ) :\DUKES, - If rY 1 u I vtiurl) <br />I INSTITUTION.Hjg* ins. State _Hospital_. _. 1316 <br />:'rest 1st Street <br />F 3. NAME OF .. Frr•t) b.1. -1 - r. II.4.rr (Nanh) (D,Y') IY." <br />DECEASED d. DATE <br />J , _(Tree Prl o Y311iam Trautman 1 } ATH January 25, 1956 ; <br />r 5. SEE { COLOR or RACE 7. MARRIED. \EVER MARRIED. DATE OF BIRTH. y iqf E IIn If I,., Y I! UnJe . Hrr. <br />11 <br />DR "ED D""RCED ISnrifrl ut i hd.yl D <br />Bale _}rhite IN, --ed Mar.21r1875 �` YO xnnrt Mi.. <br />Id.. USUAL OCCVPATION IC a kl d f rk rub KIND OF 'BUSINESS, 11 BIRTH. <br />(Cit to-f- - - <br />d ne du 1 tot ro kl 111 even If f N) OR INDUSTRY PLACE > 1 ISI— 12. CITIZEN OF WHAT <br />,< r oraran ro r q) COVtiY! <br />m , arDer ___;._> ____ ___.. _. gj;,, a [UJJA <br />Y 13. FATHER'S NAME 16.. MOTHER'S MAIDEN NAME Ddb NAME OF HUSBAND OR WIFE <br />glut- Trautman- - Rosen Switzer Trautman <br />irE -U.- -- - - _.. <br />tb WAS DECEASED EVER IN U. S. ARMED FORCES! 16. SOCIAL SECURITY I'. INFORMANT' NAN or Si. a Yre • da drem 1 <br />`x n k.owv (It > rlw w d.te. of i «) NO-Records of cast ngs ate Hosei taI <br />No <br />`:w le cevaE ox DGTxr— Ingleside, Nebraska <br />MEDICAL CERTIFICATION <br />q , Y.e pare Inkrvd R.twMn <br />_3 \ 1 I ktor 1 >I (bl..od lel' 1. DISEASE OR CONDITION .Omer ana D..,h <br />a j DIRECTLY LEADING TO DEATH - <br />°m .) Acute goronary ,thrombosis g dde. <br />u . nlq <br />;� •Tkl. dou n.1 sun rbe ANTECEDENT CAUSES <br />_3 .«..1 dA... .. , DUE To Ib ).C9rongry_grteriosclerosis,., Years <br />.y M n It1.11.rr. utbnly: Mubld e.ndltkm, If <br />�8-6 It of Ire t V M <br />sue, IN > er eawplk t► Merbl r W4) VII f <br />Ibn wkkb aued�duU ItVE TO le).._.. .. .. <br />II OTHER SIGNIFICANT CONDITIONS ((!�}}�r��yy'�O��!}1 braid $Sy{ndrp q@iipp83 Ciat <br />de E 1.t`Yaerl6l bQer ehtotie rt.riion .. , <br />1mi 1 yam._ 1 _ 1 w t. th dl _.. _ ._. ere r artier onCerose <br />.r utnlltlm l r M{ Q L 4 1 <br />O� 19.. DATE OF OPERA 18b, MAJOR FINDINGS OF OPERATION '- <br />:F TION 2u. AUTOPSY! <br />d <br />a 21.. ACCIDENT ISperlf >) 21b PLACE OF INJURY ( q I .boutT 1 (CITY OR TOWN <br />I (COUNTY) 0 Nom <br />Yer <br />pp SUICIDE ;hY f f to r t t rf bkt3.. etc.) IH ror.l It RURAL ) (STATE) <br />`( b I� HOMICIDE ) <br />S !` 4Id. TIME (Month) ID.y]1Ye.r) (Hour) 21 INJURY OCCURRED _tf. HOW DID INJURY OCCUR' <br />I e 1 OF Whik .t Work <br />INJURY . m. Not Whil. M W k <br />L <br />f 22.1 hereby certify that I attended the deceased fromAS0Pta I, +95'.5 to \!.8T1 25. <br />that I tact aaw tAe de- <br />1 b ceased anDe olklan 255, 19.556., and that death Occurred at7:.{17Am from the Causes and on the ,date stated shoes. <br />- ---- <br />26.. SIGNATURBROth A. 7Parner.l!.De 11lrrve or WO 1 tab. ADDRESB <br />26.. <br />p <br />fi <br />REMOVAL <br />Issued February 28, 1956 <br />P ) ' <br />