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004-235
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i> <br />1 <br />1 <br />h � <br />A .. <br />Issued June 25, '1956 <br />I <br />FMLtN1YE/ iEt. t WATB OF Nl�ASKA <br />mu ONN 1T <br />5 5 11345 <br />` <br />Alm <br />pRtl MO. IY{... CERTIFICATE OF DEATH ErATE FILE <br />; t nuts 61t iliW <br />f <br />COUNITI Hall .f r r' <br />_..._ ...-_..� _ _ <br />�L <br />Rr "�Ii L aoUMYT .o.. .rw). <br />_..... a9r..___._.______ <br />r <br />CfOOVR Iif weld. awawW Bdlw �rN.�Rw.11 ,lrA1 NOT N <br />l L I <br />C Itt o.lJb aaryeeV. MW., rnR. <br />A. <br />�4!� Grand_ Zaland l Llfe,_ <br />Tet!!1 _ -- Orand-- Ia3apl. <br />ail <br />L FULL SIAMR O► (It wt V hwplW > l..t{t.lf... ah'. Mml <br />NaaP1TAL oR 861, +o <br />- - - <br />d eTRERT Ilf .wd. dw N..tk.) <br />ADDRESS <br />423 heat 13th $L. <br />. <br />: -. <br />rzlerlrlrnoN 1�ilLZl0r5a:$4�?��1 <br />! !. NAMED► <br />li - ��.. � <br />+ <br />FF <br />w / 1 1 1 .,tlrt/ 7e• DATE (Mwlhl ID.t) (Twl <br />Up'BASED <br />- <br />Halt Jet.__r _1( Qnroe Dunkel DEATMfo'`_ <br />91I <br />. <br />i <br />h4 -- - - <br />�{. COLOR RACE 7. YAWED. NNpt NARpp). u DATE OP pRTN !. AOE I V It UMre 1 Y.. If U.Mr N An. <br />� �l. WWp2, ,DtIVORCED is—ityl Wt <br />0.15. 194 M a..n rbA <br />- <br />'I <br />_ <br />1 14. USUAL OCCUPATION IOIw bl.d b —1 IOL I <br />awl....ad iu.r Nb. .w. N M�9kk It. tlIBTN Id V. b.n x mmtsl ErM. t!. C177EEN��OP YVNAT <br />lrecelio�8alewn t}Q: KeI 1 4. r t�� <br />:. <br />'. <br />_'nis�.0]Ca�l� - - -- <br />! 1i. FAT7fIMWS NA E -: 1 o. MOTH 9 MAIDEN NAME ; I/L NAME OP NUSBANtI OR WIFE <br />� <br />AIRe9-11 Munkal- __.;_..haul" . 9trelo <br />IL WAS DECRASED EVRR IN U. S. ARMED FORCES! 11. SOCIAL SECURITY 12. INFORMANT'S NAME w Wl t— R,Add_ <br />IYw .w w mka.t. (If N. dw ww w d— t wrvlw) � NO. i <br />L <br />,matte _ araoe Dunker�(}}11"�n�d <br />CAUSE o► biATx� <br />I3acr�d'_ <br />Is MEDICA ERTMCATION <br />1 L D19P.A96 OR CON)HTION •F'� <br />Rw W 1.1. f.l...A / 1 DturxTLT LRAD . TO DEATNr /YJAY�VJn <br />IOMM W BNH` <br />! <br />e.1. w.... Ik. ANTECEDENT CAUSES <br />w N esM .. w. DUE 70 161 <br />, <br />>.«. <br />3 . ! Im.. Lll.ew .rlMa.. M-6,w r. Ow .ellww 1/ my. prin. _. ....•. <br />J.r. <br />... <br />Wwl. w r.r..lN.- M .wMrblw r 4.t uUE TO Irl•... <br />r..rr <br />Iw Ub" —.d "* - - .. _. <br />rd iWAN <br />_ <br />- <br />it OTNEN SIGNM T CONDITIONS <br />w M I nN <br />a aMy . <br />r.,ull«r <br />1� /O�FOPpERA 196 MAJOR FINDINGS OF OPRRATI ON <br />N. f <br />�• <br />INJURY -I,. T . <br />Al'l'IDRNT 18{rrlfyl ^Ib 1'I.AI'E OF INJURY 1 r .6nu1' _Ir. IfITY (IN TOWN? (COUNTY) <br />Y <br />._.__NO. - <br />- ISt'ATE <br />, 'ID, ,Rome, tvm. fart ntmt, 0111 • Eld. , slr 1 I1t rural .nea write RURAI.1 <br />IIONI('IDR �-- <br />Ild. TI YR I14 rat) Il ql IY-0 _ Illwrl xI WA NJ nRW 1FCVRRI.t7:D i/ II1W fill INJURY OCCUR <br />INJURY .. .,. m. N. WAID 1/W rk (] _ • -�- <br />22.1 hereby — tffy/�"fdt 1 offeN�le the deceased Jromi�a <br />ceased aID•e om"{..y 197. and that "t ooCNrred at Jrom the datb <br />7:Salam., stated above. <br />—_ <br />Tl< SIGNATURE G w or OIL) 2ah URY.89 ) 1+1 2:AFr DA SIGN <br />vac� a and on <br />��� <br />�E <br />La.L 21e. MAMBP E BRYF^TO(E1. 1 SN. BURIAL <br />O G <br />CREMAno Pe c.3 /53 Grand IslandCemetery Island <br />Grand , Hebr. <br />REMOVAL f11 rwlf'iN <br />8 S'.: \.yYVR 1 F RA IRBLTOR'8 BIGNATU <br />Uja�A.D14Y k <br />I� _ _ �.�� _ 1 <br />Issued June 25, '1956 <br />I <br />
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