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<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE �
<br />t'DEPAATM, T OF HEALTH, IT CERTIFIES THE BELOW TO 8B ,-TRUE COPY
<br />OF AN ORIGIM RECORD ON FIDE WITH THE STATE DFd;6KA;• OF HEALTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL..D� XTORX FOR
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE
<br />r'
<br />DEC 3 0 IM STAXW •' COQP$1�; 'L�ii�tECTOIt
<br />LINCOLN, NEBRASKA BUREAU OFVTTAL.;STATISTICS:
<br />STATI OF OF k n T1A W NMTN $gaols 10.0239 VI
<br />IMAII CERTIFICATE OF DEATH - -
<br />N -NAME
<br />(M... Dot. Yr.)
<br />ALLEN DALE RAYMOND Male December 13, 1988
<br />-6.r. tA�a.k.11 OaIWTyOlSCENTI. .:Iwli.w.M..IS.A. AGE- v,.aw�.r t I r t 1
<br />111ri w.lrJrs...:1�. 1Te - „axtrla•:'r� aw �. . ow:3 rl�aa.
<br />pATEOlaf�d<4611a..DaT.T•.)
<br />.. White American p �! 51 ,�
<br />Ida.
<br />, August 31, 1937
<br />AND 11fClt'A
<br />mpec.13,1988 ':Central
<br />NAME
<br />uatr t .ti..�aiM.aw1
<br />+ r�� U.S.A.
<br />De Dlhoaceory«{�/
<br />r Marrlerl
<br />�;ivingston- Sondermaau 505 West.);p� 3g, Grand Island, Ne
<br />SOCUMOECUa1TTNUMaEa YSUALOCCU PATIONg(G,..RindalwAIiis.IwigA..,
<br />1
<br />ItwoCMaUSIMUOa1NDUST”
<br />IWO q orDEATN
<br />12 506 -40 -1303 ;rte B`a�]en
<br />,,,Unknown
<br />; Hall
<br />CITT. TOWN OE,OCATION Or DRAIN
<br />M$tOE CITY UK1TS
<br />rSrrti 1( « «N.)
<br />�`es
<br />NOSMTAE 040114118 1NSTRYTTON- Mom f If ast i11.itAY. -
<br />tiN . wwMrJ
<br />'i.hrancis
<br />It+ as WO. 114k 1.
<br />mss,.•M�Wffww4,
<br />14b. Grand Island, Nebraska
<br />rw.
<br />114611. Medical Center
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<br />r' •Emerg. Room
<br />WS""CE -STATE COUNTY
<br />C1TT. TOWN On K"TION
<br />STaEET AN0 NIIMtEa
<br />Nif10E CITY IMMTi
<br />IS.• Nebraska I-%. Hall
<br />FATIEFIN
<br />1s, Grand Island
<br />115dj912 N. Sherman St.
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<br />-- 1 T1lst,al T. -
<br />WAS DKEASED fm IN U.S. AM" WatESt .T, yy,
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<br />Yes i '
<br />u oaMANT- MAW - WfA_IJONSHO -AMAJI 10 ADDRESS tsmil a ar a. ND- Cm (1a s f31r,
<br />•,'. . �
<br />1a eacetine Air Fofrce
<br />1�.Mabel L. Jennings - mother -1912 N. Sherman -Grand YME,
<br />tUWAL C►MMiM.
<br />CIDER T Oa CU MTOW -NAME ATION CITTON TOr/N STATE
<br />>a,Cr+emation
<br />mpec.13,1988 ':Central
<br />Cremation Services Nebraska
<br />C.Gibbon,
<br />- A • Uceft" tax
<br />F4141M NOME -NAME AND AUMISS Warr Qe a.10. 110. C"IT 00 WWK STAIR
<br />t1 01' EA19ALME0 .
<br />�;ivingston- Sondermaau 505 West.);p� 3g, Grand Island, Ne
<br />DATE Of DRAT!! (Mia., oft
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