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<br />WHEN THIS COPYCARR/ES THE RAISED SEAL OF THE NEBRASKA HEALTH ANQ SE RMES
<br />SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL BN i
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTTIDM1t
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS, -
<br />DATE OF ISSUANCE
<br />JUN 14 2000 L:00005077 ASSIS
<br />LINCOLN, NEBRASKA HEALTH AND HUNAN '
<br />STATE OF NEBRASKA - DEPARTMENT OF HEALTH 87 BUREAU OF VITAL STATISTICS 0
<br />CERTIFICATE OF DEATH_ �•,:
<br />'Ac -NAME FHIST MIME LAST
<br />I SIX
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<br />UNDER 1 YEAR UNDER 1 DAY
<br />DATE OfRIRTH(Me., Day, Yr. )
<br />MOS. DAYS
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<br />POTHER- MAIDEN NAME IR! M3ODL{
<br />I& John Henry Buhrman
<br />17, Elizabeth Horak
<br />WAS DECEASED EVER IN U.S. ARMED FORCES?
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<br />INFORMANT - NAME - RELATIONSHIP -MAILING., DONESS (STREET OR el D NO., CITY OR w wN, STATE. Rory
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<br />WMAL Cr@wo w, R@wswh
<br />WHEN THIS COPYCARR/ES THE RAISED SEAL OF THE NEBRASKA HEALTH ANQ SE RMES
<br />SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL BN i
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTTIDM1t
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS, -
<br />DATE OF ISSUANCE
<br />JUN 14 2000 L:00005077 ASSIS
<br />LINCOLN, NEBRASKA HEALTH AND HUNAN '
<br />STATE OF NEBRASKA - DEPARTMENT OF HEALTH 87 BUREAU OF VITAL STATISTICS 0
<br />CERTIFICATE OF DEATH_ �•,:
<br />'Ac -NAME FHIST MIME LAST
<br />I SIX
<br />DATE Of DEATH (Me.. Day. Yr.)
<br />EDWARD CONRAD BUHRMAN
<br />12. Male
<br />February 10,_1987
<br />- 10•9-. Wbite. Wec\ Aw@cicsn
<br />OfMGIKIMSCENT(e.y.,Mulian.M"ic AGE
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<br />UNDER 1 YEAR UNDER 1 DAY
<br />DATE OfRIRTH(Me., Day, Yr. )
<br />MOS. DAYS
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<br />Iwiiew. @R f )
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<br />86
<br />6b. 1K.
<br />,March 15, 1900
<br />AiiQ .ii rN 1 nM in U.SA.,
<br />CITIZEN OF WWHAT COUNTRY
<br />MARRIED, NEVER MARRIED,
<br />NAME Of SPOUSE (H rile, yne —iden A._.)
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<br />St. Libo NE
<br />USA
<br />WIDOWED, DIVORCED (Specify)
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<br />USUAL OCCUPATION (Give kind of Per! den@ swing wed KIND Of BUSINESS OR INDUSTRY ! COUNTY Of DEATH
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<br />13a. T a Kee per J.3 :Constru ion ^o Cass
<br />CrTT, TOWN OR LOCATION OF DEATH
<br />INSIDE CITY LIMITS
<br />HOSPITAL OR OIHER tNSI!TL'TfQm - Name Of "t i• @ifAer, !►
<br />MCS► OR tMST l d :cab ppA,
<br />1 Plattsmouth
<br />(Specify Ye, w Nel
<br />14.`�Tes
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<br />CITY, TOWN OR LOCATION STREET AND NUMBER
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<br />INSIDE CRY UMRS
<br />Taw Nebraska ,,. Douglas
<br />lift. Waterloo uw. Rt. Riverroad Dr.
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<br />POTHER- MAIDEN NAME IR! M3ODL{
<br />I& John Henry Buhrman
<br />17, Elizabeth Horak
<br />WAS DECEASED EVER IN U.S. ARMED FORCES?
<br />fYe., y. sr esSl • (e ,s,, e:•e wr eve/ derss M w.icsl
<br />INFORMANT - NAME - RELATIONSHIP -MAILING., DONESS (STREET OR el D NO., CITY OR w wN, STATE. Rory
<br />IR n0
<br />►P.Hubert Buhrman- Son -Lox 41, Waterloo, NE 68069
<br />WMAL Cr@wo w, R@wswh
<br />CWETLRY OR CREMATORY -NAME
<br />LOCATION CITY OII TOWN SriwiL
<br />30.. C emati n ADS. 2-117-47
<br />2&. Elmore Crematory
<br />�xw Omaha, Nebraska
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<br />FUNERAL HOME -NAME AND ADDRESS (STREET 9R R.I D NO. CITY M TOWN. STA4 . L!!J
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<br />, Swanson Fu^_.�ral Home Valle N-E 68064
<br />T!F OEATN NMe., Dog ri �
<br />_ DATE
<br />SIGNED (Me. Day. . TV.) HOUR OF DEATH
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