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WREN TWS COPYCARRES PE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAMSERWCES
<br />SYSTEM IT CERTFES T1E BELOW TO BE A TRUE COPY OF THE ORIGINAL RE H }
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL ST ATISTTitiAF�i�S c�
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS _ -- • _ �"„'� ` - = c7
<br />DATE OF ISSUANCE
<br />�� 6 1999 Of
<br />A
<br />ZRK
<br />n
<br />L NEBRASKA III
<br />NEet rra eE� E QE70LMCL. Asv�c�.s
<br />t. OE •NAIAE .
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<br />%Aw vow
<br />Dennie" D. Dimmitt
<br />Male
<br />13DATIQ01Ab
<br />February "15, 1998
<br />AND A OI r,V1moAY A. w"WW"
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<br />Grand Island
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<br />❑ t3 NAME OF ErowE A00 POW AMIM IOM,
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<br />NCR oHaRe�D Lois C. Steele
<br />T4 USUALOCCU►AT1010 a..rra.warl.w.ro • wr. TO
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<br />t{ CLICATIDN. IE{ML M{F
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<br />T{ FATHER•NALEE FM MIDDLE F t Y01 FRET MIDDLE MAIDINSUP116AME
<br />11 a - Dimmitt Dec. Ruth Lora Fox
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<br />EVER M U D F UPCE57
<br />IN OMF0AMAJf NAM!
<br />ITA►ASSIAMT
<br />IIr.I�+.«nlwtlrwaFr.aN
<br />1
<br />No
<br />Lois C. Dimmitt
<br />1EIfi01IAMFT tAA{INOADOIIESE rE11EETQ1IR DN0.CR1'ORTOWN6IATliM1
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<br />ClMETEAYOACFEMATDaY MW
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<br />Feb. 19, 1998
<br />Hi bland Park Cemetery
<br />?14 CEM ETERY pE CREMATORYLOCATION CITY (A TOWN STATE
<br />M
<br />C. (:]D."
<br />Ravenna, Nebraska
<br />]m FUNERAL HOME ADDRESS ISTAEET OR RF.0 NO CRY OR TOWN STATE NPI
<br />3213 W. North Front St., Grand Island, Nebraska 68803
<br />IMMEDIATE C� Q O /� - ENTER ONLY ONE CAUSE PEA UNE FOR ,& Of AND M:N INVrJ1I w. A.M AV aw.
<br />►ART � J♦
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<br />DUE 10 OR AS A CONSEOUENCE OF - MnrW 0.1+I.n 0..1 AM OWP,
<br />NI
<br />►A1IT OTHER SNiMF1CANT CONDtt101/S, Cem 4WIVb 0 P 0.0 VA,10IWONA FART
<br />`'
<br />AUTOPSY
<br />wAS CASE REFEARED TO MED.M
<br />PFIEC^AMCV
<br />M THE PAST ] MO,/tH61
<br />E)IAMIFER 0A CDNDNEs"
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<br />GATE OF P61tllY Ab DY, n!
<br />7{c' IIDINI OF gIIIAY
<br />M DESCRIN HOW NNURY OCCUIRED
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<br />IE. INQUIRY AT Y1011I
<br />M PLACE Qf NAB • FF np.F, IF- 0" MM.
<br />2" LOCATION STAFF T on ONO D NO C,I r OR TORN. STATE
<br />❑ HAw1.p tn..FAp�o.
<br />YIN, El ND 13
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<br />CONSIDERE Qt
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<br />WREN TWS COPYCARRES PE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAMSERWCES
<br />SYSTEM IT CERTFES T1E BELOW TO BE A TRUE COPY OF THE ORIGINAL RE H }
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL ST ATISTTitiAF�i�S c�
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS _ -- • _ �"„'� ` - = c7
<br />DATE OF ISSUANCE
<br />�� 6 1999 Of
<br />A
<br />ZRK
<br />n
<br />L NEBRASKA III
<br />NEet rra eE� E QE70LMCL. Asv�c�.s
<br />t. OE •NAIAE .
<br />EE
<br />%Aw vow
<br />Dennie" D. Dimmitt
<br />Male
<br />13DATIQ01Ab
<br />February "15, 1998
<br />AND A OI r,V1moAY A. w"WW"
<br />Sa LM YMI,
<br />T
<br />- - UNOEAI DAV -
<br />{ 0,0 OF SMH AMIIII Dy Wry
<br />Wa1Vo'rth,'Nebraska
<br />mal Et
<br />62:"-
<br />U06 ars
<br />I
<br />Sa HOLRE � 4tNf
<br />September 10, 1935
<br />"
<br />KTMI� Ot�1ERI ❑ TA+•+wtb^+
<br />508- 40-0773
<br />a EAomoom o
<br />ft FACUTY. NM,AI ,.a..r..MFt»....1F -.P ,
<br />p GDA p DM 00aw
<br />ft .tawonLDCA. DEA -..
<br />w M{EIE LIHS.:
<br />w COUNTY DEATH.... -
<br />V N. o
<br />Hari
<br />k A - E►
<br />. TOWN OR T *k
<br />N iz
<br />effirkwe
<br />Nebraska` Hall
<br />Grand Island
<br />2307 N. Sherman, .68803
<br />r» ®«. ❑
<br />10 - 11S.119ft MOM A"INIMWw
<br />TL E N{ trn MMlMn «I )01111@MANNO
<br />❑ t3 NAME OF ErowE A00 POW AMIM IOM,
<br />«�I�EaT•R White"
<br />American
<br />NCR oHaRe�D Lois C. Steele
<br />T4 USUALOCCU►AT1010 a..rra.warl.w.ro • wr. TO
<br />,
<br />IMDOFSUSINKSSMOUSTOW L�
<br />%.
<br />t{ CLICATIDN. IE{ML M{F
<br />of - VA ~0 II.M _
<br />q5%
<br />EMMMItlY I EIAIAEMY A 1n CIIpr ,1 A a 0•,
<br />T{ FATHER•NALEE FM MIDDLE F t Y01 FRET MIDDLE MAIDINSUP116AME
<br />11 a - Dimmitt Dec. Ruth Lora Fox
<br />t{ w
<br />EVER M U D F UPCE57
<br />IN OMF0AMAJf NAM!
<br />ITA►ASSIAMT
<br />IIr.I�+.«nlwtlrwaFr.aN
<br />1
<br />No
<br />Lois C. Dimmitt
<br />1EIfi01IAMFT tAA{INOADOIIESE rE11EETQ1IR DN0.CR1'ORTOWN6IATliM1
<br />2307 NO Sherman. Grand Island Nebraska 68803
<br />{ NO
<br />214 WTHODOFOaFOnTom
<br />n{ wT! ttt
<br />ClMETEAYOACFEMATDaY MW
<br />TQ;;
<br />nx - - �AF.nrR
<br />Feb. 19, 1998
<br />Hi bland Park Cemetery
<br />?14 CEM ETERY pE CREMATORYLOCATION CITY (A TOWN STATE
<br />Kleine Funeral Home
<br />C. (:]D."
<br />Ravenna, Nebraska
<br />]m FUNERAL HOME ADDRESS ISTAEET OR RF.0 NO CRY OR TOWN STATE NPI
<br />3213 W. North Front St., Grand Island, Nebraska 68803
<br />IMMEDIATE C� Q O /� - ENTER ONLY ONE CAUSE PEA UNE FOR ,& Of AND M:N INVrJ1I w. A.M AV aw.
<br />►ART � J♦
<br />I'm
<br />DUE TO DA AS A CON ECILVACE OF ......w..."n.1 .o...n
<br />1► C ✓% e
<br />of {..-„v OAo
<br />DUE 10 OR AS A CONSEOUENCE OF - MnrW 0.1+I.n 0..1 AM OWP,
<br />NI
<br />►A1IT OTHER SNiMF1CANT CONDtt101/S, Cem 4WIVb 0 P 0.0 VA,10IWONA FART
<br />■ IF FEMALE WAS THERE A
<br />AUTOPSY
<br />wAS CASE REFEARED TO MED.M
<br />PFIEC^AMCV
<br />M THE PAST ] MO,/tH61
<br />E)IAMIFER 0A CDNDNEs"
<br />U{n
<br />iQeN Yw NF `Yw
<br />b
<br />rw Mo
<br />GATE OF P61tllY Ab DY, n!
<br />7{c' IIDINI OF gIIIAY
<br />M DESCRIN HOW NNURY OCCUIRED
<br />C71!
<br />❑ ATAywA ❑ U'lewu"r's.
<br />M
<br />❑ Src4. ❑ P. a.
<br />IE. INQUIRY AT Y1011I
<br />M PLACE Qf NAB • FF np.F, IF- 0" MM.
<br />2" LOCATION STAFF T on ONO D NO C,I r OR TORN. STATE
<br />❑ HAw1.p tn..FAp�o.
<br />YIN, El ND 13
<br />DAtE OF DEATH /W 00 "1
<br />716 DATE SIGNED rW 0Ar r.,
<br />7Ie 1IE OF MAY"
<br />s
<br />C�- q�
<br />M
<br />{
<br />DATE SIGNED Ab OI/ r,,
<br />TIE OF DEATH
<br />7{C PRONOUNCED DEAD .W aW Y.,
<br />_
<br />2{P PtiOFID1IN(.EUOf.AD /rbv�
<br />y
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<br />RX8
<br />T.Me.Ft A11w/.,1A.,.AI. W.P,ab...0•IgM enr.W FI.t. AM O�NFn
<br />"q,
<br />/alwA{ /t�r0
<br />See 28e.
<br />M Mw. IIF A,M DMtu MA Oir 1. N
<br />T
<br />MY
<br />CprtWBUTE TO THE OEAT M
<br />. HAS ORGAF /OAT /tDN OCEN
<br />CONSIDERE Qt
<br />AS CONSENt ED
<br />Y's NO El UNNOWN
<br />l_ YES 0-
<br />C7
<br />0.S
<br />Richard M. Fruehling,.MP 2116 W F idle Ave. Ste 400, Grand Island, NE 68803
<br />Y,. FIEOI$TRU1 3M DATE F4EDBY11ECJ51RAR Ab :Mr ,.)– _
<br />FEB 2 6 1998
<br />v -
<br />Lot Twelve (12) and the Southerly Sixteen and Six Tenths Feet (16.6:) of Tr)fi TPn (in) nii ;t,
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