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<br />WHEN THIS DOPY CARRIES THE RAISED SFAL OF THE MR1MK&.STATE
<br />DIpARTMZmT OF HEALTH, IT CERTIFIES THE BELOW I #4 W
<br />OF AN ©RICINAL RECORD ON FILE WITH THE STA91" Or HEALTH
<br />WjtUU OF VITAL STATISTICS. WHICH IS THIS lAw jodlifty- FOR
<br />VITAL RECORDS.
<br />ot►Ta of IssuA>"ca
<br />JUN Z 810 suarr a...po�stt.: blRacTOR
<br />LINCOLM, NEBRASKA M1R>RAU OF VITAU STATISTICS
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<br />85 02139
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<br />CERTIFICATE OF OWN,
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