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<br />WHEN 11115 COPY CARRILS 1.11F HAISED SEAL OF THE NEBRAS)u% SPATE
<br />ULPARTMENT (IF HI'ALTH, IT C1111TIFIES THE BELOW TO SE A TRUE COPY
<br />OF AN ORI( INAI. RIX01U) ON FILE WITH THE STATE DEPARTMENT OF HEALTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITORY FOR
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE
<br />SEP 15 a? STANLEY-9. COOPER, DIRECTOR
<br />LINCOLN, NEBRASKA BUREAU OF VITAL STATISTICS
<br />-- 89401106 102689
<br />STATE OF NEWUU -0 MNTMENT OF NEALTN
<br />SUFA J 0/ MAL STATIST%$
<br />CERTIFICATE OF DEATH,
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<br />DATI 01 WAN ( T,.,)
<br />Rose
<br />Ma Robinson is
<br />Female
<br />September 5, 1987
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