Laserfiche WebLink
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
PHS- 74,VS REV B -SET STATE OF NEBRASKA <br />DEPARTMENT D PUBLIC HEALTH. DEPART^.HE OF HEALTH <br />DEPARTM N AND 'PUBLIC ` <br />Bureau ut , (tal Statiut- cl t u 4 3 O, j <br />BIRTH NO 126 CERTIFICATE OF DEATH >MIATE FILE NO <br />I •EAOC[NOI -.TN 2 ... AL E.—II -11E r1... a.....r, 11 �+.r.Iwa, a.—W. J --) <br />Hall - Nebraska e C...'• Hall <br />e CRY Tea'M U L «,TiON l I LENGTH 11 1-11 N le r CITY T11M Ua L «,TICI <br />Grand Island Nrr B RE,. brand Leland <br />A.'wv rwr a ,dd.m nqL <br />St. Francis Hospital 1010 ',Jest 9th <br />< R .L,C[ a OUfw inSiJt CITY LIn IT91 YES MO r IS RESIDENCE NSICE CITY ­ITS' YNED S (] ND$❑ 1 / FAA+ aElI DCMCEI Y <br />7 u. f'irn <br />OlEC U ,Vrd4e can L DAYS 14-11 Dal "I <br />wDS[M Edward Washington Spink 1 a TN April 7 1962 <br />(JyJN r Rrr,n <br />SE1 6 C1101 Da PACE 7 NARaIEO ® NEVEa MARRILD 1 DAT( Or BIRTH 9 1G['1. Brarr I f UnD(II rCY y uxDU M ne <br />Hale I whit! I r1DOwED❑ .v EDC �_c• 19, 1686 ranpr uw, <br />101 SU.L «CUgA'gN ICw YrN1 a(. rJ Ecru 100 RIND Or Oa INOUSTgY Brq Tw.LA�F .VNY n (or<4+ rou N.YI 17 It GrtILU as Nr4t _.Y' <br />Fe�ile�r freJ2i !�i'rn,u,n, fire - <br />J fighting Ashland, Neb. U. S. <br />ij. W.I. J NAME I S MAIDEN WANE t. NAY( O1 Nu51ANO 01r r,,E <br />Francis Spink ie _______ I Anna Guillemont Soink <br />I{ SEAS DECEASED [a I+ U B A +uEDEglI SOCIAL SECURITY M 11 IN701.— Addrrr <br />no no 506 28 0274 Anna Spink. Grand Island. 7.1 rpsid <br />IM CAUf[ W D[A7M (E +rn .n11 one rawe ReE riw< 7111 1e 1. .nd (rI IMERV.L 1ET VEU <br />P1AY I «.TN rAS CAUSED 1r ' A DEATH <br />INnLOUn CAUSE (uyr n u rc�' r0 h�i t7S I C <br />• CondlNonr. r /Rn1. DA TO 16) <br />�JM1 rrr !ur D. TO III <br />r 1117 11 ( 1 1*1 —IT" Cg1RIBI 11 TO —11 Syr 1101 R[lArtO TO 11 RJIYINLL DIS(ASE CONp TOM 11— W 1"1 11.1 11 rA1 AOTOaSY <br />RRipRM[��,OyyyL <br />YES ❑ ND Ip <br />2D+ ACCIDENT B ... N .Y Of I2M DESC.11( w01B INJURY OCC—ED 16.(n nngrt .J rn/u,5 i+ rW 1 r Pnl 1l sf y <.1111 I <br />❑ ❑ ❑ <br />gill, 1III I.i_. Monra, Del. 1.w <br />71 20L INJURY OCCLIRED 1�' nlci as Iruua. I. r,{ �� aAor bti. 2D, CITY. TOr+. Da LOUT ON COUNTY ST.n <br />A, Mn ILE.Y ❑ nOT WNIL( ❑ rr.E, hrrrB. dreel, .aici 07d1.. dr.) <br />wola •T X. _ <br />zJ, t.rr.wd.e 1A.4.1• a,E7° U — 1 G <br />7` D—A . ..... d.r r�S a ow rM d. [, .t. t.d.Do.., .nd t. rh, e..e d ny 1n..bdd., h.- M. uu.w rrwr.l <br />121 11D u tkprr r 1 1 7b AD ss Ur. an SICRD <br />iJ{ 1URIy CAL u' 01 2Y <br />DATE 2J NAn[ a CCN[TC1Y OA <RENATOar `2L LOCATg1 {C1fI, ro +' +.> [w.l,l srrJ <br />ur tip° IJj1 �k- 11- 6?2_'_ Westlawn HemoriAl Park 1 Grand Island _- Neeiraskra Ica <br />". 2{. wn RECD 1Y u41sT1Aa ZIE 810-11 111 S SIUNATGR[ 21 1111 01 M01TUA1Y 11-1 <br />d , . Livingston- Sondermann, Grand bland, Neb. <br />