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89-- 10231.4
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A TRUE COPY
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMENT OF HEALTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITORY FOR
<br />VITAL RECORDS. :
<br />Aw
<br />DATE OF ISSUANCE
<br />•''`= �- FEB 19 10. STANLEY S. COOPER, DIRECTOR
<br />j
<br />xk,'��P'3 , LINCOLN. NEBRASKA BUREAU OF VITAL STATISTICS
<br />The blest Four (4) Feet of Lot Five (5) a.ad all of Lot Six (6), in Block Two (2),
<br />in Naves First Addition to the City of Gmad Island, Hall County, Nebraska,
<br />,� excepting a certain tract deeded td :tares B. Campbsll :ncf Tamra L. Campbel.4,
<br />CTV_ -% ? °/ """), $.;,�. recorded as Document No. 88- 104829.
<br />STATE OF W_ftASRA —WA9 M Mff OF W IR t
<br />IUKAU OF YRAt sTAnST' Sr
<br />CERTIFICATE OF DEATH - or
<br />0! EDlN -NAME YI AMOM LAST ?Avg oEATN (Imp'. or. r..)
<br />T Lillian Esther Madsen 2 Female 2 Feb ary 12,. •19•t38
<br />wax.. RMclAwrsr. ORIGIN /DEiCEraTfr.R•.hw�iM.M/st.. .Pte&- :rasw.<ti., Z u I Y AZ♦ 'NOU T D4Y owTIO�NRtf/eMr.01s rtJ
<br />rw/i.w, Mr1 CrNt.l>•1 Gwwr4.lt )lir.rdj) LT.oai •AIDS. DAIS NOUti M,NS.
<br />•
<br />• s. Danish �►
<br />White` �.. 75 ,April 7, 1912
<br />Q FY A.NOSA GisIRTi'1rK'wNirU.S•A., t:RTzlNOr W:CC'<J itt. E .NRVERAIM . NAME OFSPMSI(N.dA.O�w,.d....w.)
<br />'ame r••w►* ng00WE0. OIrOR[tOff�.a/Y, t
<br />! Danrte%r Nebraska , U.S.A. };t Married „Ewald C. Madsen
<br />socuwsECUrrnNUMIRER uWASOCCUa .*IONrG:..Irwdw...Arwa.c••E•wr RINGawflNEUORINOUSttY touNTrofDEATN
<br />rls "O r.T, .... ir.a.,.a
<br />,E 508-46 -7114 >. fe Ts. (Alm HGRIe Iss Hall
<br />CRY TOWN on WCATION OF OUT" fNS1011 coy ttwlT3 MOSIRAtOlOTNllt/ isil°"y".f701f- ►fw.rl /Mr.w.AM., NwDypRfN, ►frftM,rtaCx_'"
<br />Nebraska (fr «,r,r..r.lY.► On.d4rM..rA.rAN) orwr.w,r.•.• In.w..r,- ,= l+w+n^
<br />T Grand Island, ,4, Yes Tw.St. Francis :`medical Center Irr. Inpatient.
<br />"SIDlNCE -STAT! OMJN" CITY, TOWN ORrOCAnoN STREETANONUMRlR IM(yDlCITrUMRS
<br />Nebraska ?Sb. Hall 115,. Grand Island 631 Memorial. Drive � �es
<br />T,,.
<br />A U1 - N
<br />(dec) Paul Christensen, Sr. t., . (dec) Katie Wilbe=ina Jensen
<br />WAS OKIASIO MR IN U.S. AWlD IOKIS10 ► NrORMArrT�MAIrE- ersi,►rrONi)M/- wuuNry w00Rtfi wTRr>t�E ar 0, ate C.5 TOWN. sratt•s�
<br />Rw •.� w ..q <M ,w. r.w.n.y �.,, rw•..,
<br />it NO. ,.. Ewald C. %dsen- Husband -631 Memorial Dr. Grand Island,
<br />lurAK ct.rtl , ft"
<br />UJAITERy OR CREMATORY -NAM! i LOCATION . - Crt►OR TOtwr STAINVU
<br />p. Burial
<br />2 -15-88
<br />Westlawn Memorial Cemetervf,, Grand Island, Nebraska
<br />ATUR8 f UC MSE NO. ;t 019 04
<br />UNUM NOME - NAME AND ADDRESS rr71pT Or W+D 'NCI_ C'1 ?s TOW,► STATI. M
<br />„
<br />Jacobsen Funeral Hw a 411 °CI "f Str. St. Paul, Nebraska
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<br />�'s�y� n.. February 12 1988
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<br />David R. Colan, M.D., P.O. Box 2339 Grand Island, NE 68802
<br />DATE 11C91VID
<br />!r. r FEB ± 8 )988
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