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4/12/2012 10:28:02 AM
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4/6/2012 2:51:40 PM
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004-565
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f <br />RECORD OF DEATH <br />STATE OF NEBRASKA OFFICE OF CITY CLERK <br />M <br />COUNTY OF ADAS <br />CITY OF HASTINGS HASTINGS, NEBRASKA <br />of <br />THIS IS TO CERTIFY THAT THE RECORDS IN THIS <br />OFFICE PERTAINING TO THE DEATH, <br />(also known as Evea Harris) <br />Eva M. Harris —1, <br />Died on <br />Place of Death <br />Name of Physician attending <br />Age Time of Death <br />o <br />June 29, , 19 55 <br />Hastings, Nebraska <br />G. Paul Charlton <br />67 <br />Place of Burial Parkv -few Cemetery <br />Funeral Director �„'..s 4 y; t Brand Mortuary <br />gas July 5 <br />Death Recorded by 1464 bi} , 19 55 <br />Dated at HASTINGS, NEBR S 1, . .fit' 4t' day f Jul 19 57 <br />�ie <br />t City Cle)+ and Local Registrar <br />HIDE PRINTING CO.. HASTINGS, NEBR. <br />X <br />�, �.� <br />`��; � <br />"• <br />::, <br />w era � <br />. <br />
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