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THIS CE$TIFlF$ .1 EAI36VOJ— O;%'k'l -,TRUE COPY OF AN ORIGINAL <br />CF,XTIFICAT CI NFJ;L�.,)V ' ( HSTATE DEPARTMENT OF HEALTH, <br />BUREAU, Ol5 VI SS �WCH IS THE LEGAL DEYOSITORX <br />FOR VITAL <br />DIRECTOR OF VITAL STATISTICS AND ASSISTANT STATE REGISTRAR <br />LINCOLN, NEBRASKA <br />5tmte of Nebraska ' <br />Cc'unty of hall <br />Eatered on Nvinerical Index and filed ' <br />for record- an (-if ;ce of Register of <br />C d§ ca On :. _7 ........ day Lf <br />at - <br />o'c oc's an l Y6- Minutes _4• M - <br />ard recgrd ;a Pojk ,_ �� _.. of <br />^j ease. <br />Register of Deeds <br />By -- - . - -- -- --- - - - - -- Deputy <br />.Fees - -_ <br />