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<br /> �1�MEi3 THIS COPY CARRI�S THE RAISED SEAL OF THE NEB1211�KA STATE
<br /> UEPARTMENT QF HEALTH. IT CERTIrIES THE BELOW TO BE A TRUF COPY
<br /> OF AN ORIGINAL RECORU ON FiLE WITH THE STATE DEPARTMENT OF NEALTH
<br /> � BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITORY FOR
<br /> __ VITAL RFCORDS.
<br /> DATC OF ISSUANCE ,� �j
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<br /> DEC Z �, � STANLEY S. COOPER, DIRECTOR
<br /> LINCOLN, NEBRASKA BUFfEAii�OF VITAL STATISTICS
<br /> ��TE OE ME�RA9KA—OEPAR'TMENT 0�MEALTH
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