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Last modified
4/16/2012 1:50:16 PM
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4/13/2012 9:49:44 AM
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007-519
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r a <br />126 <br />,'IATE 01- NEBRASKA <br />DEPART-ME-NI OF HEALTH <br />F,-- Of Viul Statistic, <br />CERTIFICATE OF DEATH N,l <br />T <br />. .. ....... <br />Y I} -Ul <br />Jon Xaz,'-niPrl:i <br />1M n <br />FOR 1 7 7 FO. <br />Y... on, T. 3 r-- 11 <br />ri� Encvolds <br />A rA <br />OFF TO (0 <br />w—v,—iu 0 <br />RI—I "I <br />"T i1G tr <br />-26.7 —T <br />Rj REAC R, ;N ,1 4, R 20f CITI. TOII OT —A—N clIjIll Tf <br />...... ... <br />-5-T fl, ❑ L! ..... <br />AT —d <br />21 1 .1—d- the dace —d I- <br />Dos:h M. d- <br />01 1' ITIRI O� IRI-,�oRy .. ......... <br />23� .1- IITI <br />939 St. �Lnthny- Catholic ory 'L rweil, Yebz <br />24 DATI RICO 1, 111',TRAR 25 5 S,GNATUPE X26. NAMjrOF N ORTq�'l A-111 <br />qE <br />/"`, )) '-f— 7 St. Paul, Ncbr. <br />0 <br />a <br />
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