T 770 riorER.L 110U A 'r 191 E Oa 7 0 O CI1Y 10Y415 S MI
<br />a -, 32 r - North - r — xeet tiR 14n1 N�,..s1,AI«•I.N.n
<br />D u1rN aDd UN a CAU Pln LINE r00 .M AI 0140 law
<br />Pool
<br />0i
<br />ta I W * ' Ina • _& 1
<br />MM.N,MMAn91V.1 40.0..• tL. Mt 1D. AS n SF•IUErSE1N -
<br />U 011 '� :_ [ ...• 100 1404110.01.
<br />IYI -_r mu 1018v wA$C19E ti 'ED OMEDCAL
<br />oMl
<br />QINER 1( INFICANICOIIp11pJ $•CPVN'^^.iM/r0xIblFNeM0,01A fA1rW 0114011 P11111M1CY F11I4 PAST 1 0104 PANT IN 11 FEMALE WAS rNSREF 145E 11010 OR CON9IER
<br />Plgn 10 711 vei � ND El YM n lb 1 � Y0a n NP •
<br />PM $7- 041E0 MIPJnv ,W TAM ,•1 1R• 10x Mtge 1110! IIM ' 280 OE SOME NOW NAP r • -
<br />0 .07107,1 0 U.P.W.. - r M
<br />4514,4, 54wWr1 RL
<br />!.. 11nY At WQIM !N P n' E OF IN Illy • NNOpY 1,144A 11
<br />.A .01 N0.10v .II lOC
<br />AIIUN 0100 M0 01 AA InMN 07A50
<br />O 151041 . 1.
<br />0 .r... PP- SIA.4. 101 111 I - 0
<br />;r . 1 011. •1. N I 1 00 IMl STONED YP IMP 171 7.01 100E OF OEAIN
<br />. �r� MI 7anua� 18 2001 M
<br />th C ECADIIED 0a. I.,„. III MA of UCAIN a t .1 0111 I0IONUIPICFDUFMI dM Ws WI 701 PWIAK NIW,r tI DE.O Pe.rl
<br />'i M
<br />J,U
<br />Iar , • Mi 1 °� 3 • •
<br />Q ? . 10 04 0131 011 .14101" • IYfuiM•IN�ryN.EY Silt rbl. 041 FImim.
<br />d4mEN . D. nova 0555* 61001•08 I 0
<br />04. n4,.0.411 011.1RWe0N
<br />♦ NA MYe O1N1MPI175 IRS NJAIO bMtN1NN7WF
<br />1010.•1.1 VAI
<br />t5...9 eM 1IMl A 1 19..417001111Nb11
<br />9 ON DOCOUSF CANt� 151011 i1 1 M1 � 111.8 111.WOW WOW on maim otIW I1ow'EEN CCMBIDEREU, 7b(w4SCONSBNT
<br />•\ yr9 V 0 YES ® ND ` ❑ TO rq
<br />3* NAME /MO AODAISS Or Cf111KIER IIRIS 10AN, CORONER 5/4145112014 OR I 1 1111 0 7 7 1 I1p5
<br />Ry,M D CESMO MD,. 800 lI Al iha Rt.., Granr�Ta) aT1r� Nebraska 11 0 a 3 R1wR No. ar 9 4
<br />.22. 010151 RAR
<br />rlp9. 1 1.11 STATE OP NEDRASE EN
<br />A- DEPARTMENT OF NEALT11 AND HUMAN SERVICES FINANCE AND SUPPORT
<br />VITAL STATISTICS
<br />CE RTIFICATE O DEATH
<br />OUE 10. A 01 IN
<br />201305600
<br />FOR VITAL STATISTICS USE ONLY
<br />A 8. ..C- 0 E...._.__ ...........Part 11.._ .....TMV _....._ ..M.
<br />P1AC @........... ...._. _..... »....• - ......... .:.» ..... ..... ..__._.........._...__.... ....• • .••w ,_. ___...»... ._._. „.__._. GEfnSUS Tract No.
<br />UC........ .. _...... _.... .... . _....,..— .._..,.»
<br />.«.............. ,� PmI. 1 .101.50 IM 5..000140 Per.• .. .....
<br />I UES:EUFIII •• NAME
<br />NISI 018110,4. tA3t !
<br />! SPX 2
<br />2 DAIS 01 C811191 0µ5N Our 9►wl
<br />Delbert Morris $
<br />»a •Of•LOS 10111419 W
<br />WIDER IYfAR t
<br />tN1UER10AV E
<br />E DAtE Or BA/ N 14b/t YeYf
<br />w MO9 OAYS s
<br />sc HOURS I•W5 M
<br />z r
<br />r }
<br />A. M AGE OF O %III
<br />/OSMIAL 0 Avw— OnEw 0 1 o 'o'w..
<br />00 rACR11r•M9.e Hnr.r.MMR00•Urr..•I•.,w /•0010 S
<br />7 / Y��..
<br />• on* 0
<br />F 0,111 IrnYN Ur11N'AIAW511F.A111 1
<br />1.1 PIRKM0ov oal I9 a. CAIU SIP Or MAIM 1r
<br />.Island .
<br />PO 8001v P
<br />Pr, 1)tY.1t)NNWi1.00AEKW 8
<br />, 1
<br />80 WEE r AHU NUMBER 00,00•117 1 MN a
<br />Y« RI no ❑
<br />11. ANCESInr 01.0 A•11410 4/0400 .re.n 141100141100110, O
<br />icl I
<br />I? ® MAMBO 0 IMU 0 WE 0 +
<br />is LIME Of 8I•OUSE b' P v�'r'AAMA'• WaWr
<br />White A
<br />1S EOUCMPON 131401.0910oerV+0 b01
<br />E twat
<br />'s*
<br />IA. USUAL OCCUPAIN)FI AMP 1 0 0 00 1 00. rn•.UYrY0.A. 1
<br />1401 moor BU31NESSIMOUSIPY 1
<br />E4W,O Sec -w'. 10 171 War War il•A. 5.1
<br />15 IA IHEO •NAM., Mal M11KriE L 051 1 I MUIN.0 11PSI POPE MAIDEN fU0NAME
<br />TS MR OECEASF.O Ciro xl US WIWI) 90110ES WW/ yjjnarr u
<br />um INrOFVANI .NAM.
<br />Yes 06 19 194 -11 91/1
<br />I0 egQRUANI MA%INDMNIPESS WORM 0101j NO CM cm 10WN SIAIE IIPi
<br />1818 Barbara, Grand Is ntt_Nebraska 6
<br />711 CEMCIfiM OR OPEIMIp1r 540E
<br />?A r',I Ueg• 0O) AI. R MD 9
<br />914 MEN1000FDSPOS+n1N ?
<br />?IO D
<br />)10 CEME1e OACa7MA1rJDY LUCAIION UI r UI110wN ST/11E 7
<br />771 TINE OILIIUMF.•
<br />Kleine Funeral Home ❑
<br />IYI -_r mu 1018v wA$C19E ti 'ED OMEDCAL
<br />oMl
<br />QINER 1( INFICANICOIIp11pJ $•CPVN'^^.iM/r0xIblFNeM0,01A fA1rW 0114011 P11111M1CY F11I4 PAST 1 0104 PANT IN 11 FEMALE WAS rNSREF 145E 11010 OR CON9IER
<br />Plgn 10 711 vei � ND El YM n lb 1 � Y0a n NP •
<br />PM $7- 041E0 MIPJnv ,W TAM ,•1 1R• 10x Mtge 1110! IIM ' 280 OE SOME NOW NAP r • -
<br />0 .07107,1 0 U.P.W.. - r M
<br />4514,4, 54wWr1 RL
<br />!.. 11nY At WQIM !N P n' E OF IN Illy • NNOpY 1,144A 11
<br />.A .01 N0.10v .II lOC
<br />AIIUN 0100 M0 01 AA InMN 07A50
<br />O 151041 . 1.
<br />0 .r... PP- SIA.4. 101 111 I - 0
<br />;r . 1 011. •1. N I 1 00 IMl STONED YP IMP 171 7.01 100E OF OEAIN
<br />. �r� MI 7anua� 18 2001 M
<br />th C ECADIIED 0a. I.,„. III MA of UCAIN a t .1 0111 I0IONUIPICFDUFMI dM Ws WI 701 PWIAK NIW,r tI DE.O Pe.rl
<br />'i M
<br />J,U
<br />Iar , • Mi 1 °� 3 • •
<br />Q ? . 10 04 0131 011 .14101" • IYfuiM•IN�ryN.EY Silt rbl. 041 FImim.
<br />d4mEN . D. nova 0555* 61001•08 I 0
<br />04. n4,.0.411 011.1RWe0N
<br />♦ NA MYe O1N1MPI175 IRS NJAIO bMtN1NN7WF
<br />1010.•1.1 VAI
<br />t5...9 eM 1IMl A 1 19..417001111Nb11
<br />9 ON DOCOUSF CANt� 151011 i1 1 M1 � 111.8 111.WOW WOW on maim otIW I1ow'EEN CCMBIDEREU, 7b(w4SCONSBNT
<br />•\ yr9 V 0 YES ® ND ` ❑ TO rq
<br />3* NAME /MO AODAISS Or Cf111KIER IIRIS 10AN, CORONER 5/4145112014 OR I 1 1111 0 7 7 1 I1p5
<br />Ry,M D CESMO MD,. 800 lI Al iha Rt.., Granr�Ta) aT1r� Nebraska 11 0 a 3 R1wR No. ar 9 4
<br />.22. 010151 RAR
<br />rlp9. 1 1.11 STATE OP NEDRASE EN
<br />A- DEPARTMENT OF NEALT11 AND HUMAN SERVICES FINANCE AND SUPPORT
<br />VITAL STATISTICS
<br />CE RTIFICATE O DEATH
<br />OUE 10. A 01 IN
<br />201305600
<br />FOR VITAL STATISTICS USE ONLY
<br />A 8. ..C- 0 E...._.__ ...........Part 11.._ .....TMV _....._ ..M.
<br />P1AC @........... ...._. _..... »....• - ......... .:.» ..... ..... ..__._.........._...__.... ....• • .••w ,_. ___...»... ._._. „.__._. GEfnSUS Tract No.
<br />UC........ .. _...... _.... .... . _....,..— .._..,.»
<br />.«.............. ,� PmI. 1 .101.50 IM 5..000140 Per.• .. .....
<br />rlp9. 1 1.11 STATE OP NEDRASE EN
<br />A- DEPARTMENT OF NEALT11 AND HUMAN SERVICES FINANCE AND SUPPORT
<br />VITAL STATISTICS
<br />CE RTIFICATE O DEATH
<br />OUE 10. A 01 IN
<br />201305600
<br />FOR VITAL STATISTICS USE ONLY
<br />A 8. ..C- 0 E...._.__ ...........Part 11.._ .....TMV _....._ ..M.
<br />P1AC @........... ...._. _..... »....• - ......... .:.» ..... ..... ..__._.........._...__.... ....• • .••w ,_. ___...»... ._._. „.__._. GEfnSUS Tract No.
<br />UC........ .. _...... _.... .... . _....,..— .._..,.»
<br />.«.............. ,� PmI. 1 .101.50 IM 5..000140 Per.• .. .....
<br />
|