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<br /> • • {iliEN THIS COPY CARRIES TflE RAISED S�AL OF THE NEBRASKA STATE
<br />� � � DEPAATMENT OF HF.ALTH, IT CERTIFI�S THE BELOW TO BL� A TRUE COPY . _
<br /> Ug AN ORIGINAL AECORD ON FILE WITH THE STATE DEPARTMI3NT OF BBALTK - -
<br /> � � SUREAU OF VLTAL STATISTICS. WHICH IS THE LEGAI. DEPOSITORY FOR
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<br /> VITAL RECORDS. � � �
<br />_, , DATE QF ISSUANCE• �d��' �__.." '
<br /> `F: -�'� STAN�.EX �:_COOPF�R, D IREC�OR
<br />� `' ' JAN 12199� suR�u:o�=__VI�AI._STATI9T�CS
<br /> .,_r.: LINCOLN. NEBRASKA . _- - , . -�-__-
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