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f� 103823 -1 <br />WM THIS COPY CARRIES THE RAISED SEAL OF THE NEB&il$� ;SST <br />DEpARTMBNT OF HEALTH. IT CERTIFIES THE BELOW TO BE 4 1E°,CORY <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEFART!'� OP HI&TH •. <br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITORY FOR <br />VITAL RECORDS. ��" ' <br />1' <br />:.: 7 <br />DATE OF ISSUANCE - 1 <br />JUL O 1969 STANLEY S. COOER, .DI:�B�C'rdR <br />LINCOLN. NEBRASIU► BURUU OF VITAL,.STATISTICS <br />STAU V NOWAM- MMOSAVOff 41'"2" <br />N� A"STM 86 0929 <br />CEWnRCAMLQf DEATH . , <br />A fA,-., O•r. T.1 <br />NOT <br />Jarrett Josiah Hare le Au ust. 2, 1986 <br />wwftM *.. u.+i.w. rw..e... -u. a+w- + <br />o•.7American )ftr•saY) frn.) .ws. � Iwai' ,June 23, 1899 ' <br />Whine 67 <br />sun owr MrMY.1A. <br />WHATC ou" <br />Z'Ousk <br />wrooweo. tarwlclo ftiT,r) <br />Married er. Mar B. Coleman <br />Nf "Omer) /t t Ohia <br />ocwA <br />,o. <br />�.w.r•.sra..a•�r�•+ ro ot+ <br />co+n+TraolATN <br />' <br />3506 .0T.- 993 , <br />em.TOw•r H7RAT+ONofMATN <br />rN3+flecmtMYT3 Nai+ tA�oROTM lI+wsmut+o»- rt.••fMwr�.slw.•. <br />" .�* w:-°.°OnwMl <br />ftdrTwrN•) ii.n • ...bH <br />Praucis Medical Center <br />„-In atient <br />Grand; sland, Nebraska <br />Cfi+ltO� <br />,... <br />yea ,-r� <br />"0m+OCAT tT lTArIpTN1M3lfi <br />C+TT, Tt.— IOM <br />,Ni+olCml+M+/i .. ,- <br />ft,•arrTNrlWI <br />NC! -iTAT! <br />Hall <br />+%,,Grand Island +si. 419 South Clay <br />,s- es - <br />-. r tbraska ,�►` <br />A <br />IL + Henry $. <br />Anhnnon <br />Hare .caz..c.o -- - - <br />wiA+ e- !!ur)oNSNrr- .1A1►Ifr.�At+Ot+lu" aT�.ro.r..� got <br />wAi o!c"mo <br />fxm .w."v <br />RYlfi NI Y S. AfMIlO TgfiClif <br />IM,.w..w~."adw alm"4 1. <br />+rMGtl1AN T- <br />B. Hare Wife .419 S. Cla Grand Island NE <br />• .,*.N <br />.. <br />, *m!a <br />cr2amOsCGIVA10mv -N.IA! <br />TATS <br />IOCAT+ON CmOo10MrN iTAT! <br />' S�sria; <br />.August 5, <br />• 19 <br />Grand Island Cemeter. <br />Grand Island Nebraska <br />>~n <br />uw— -NAMl wr+o AOOl+t a *ta a. r.� I O. c"n On "A>r. 68801 <br />137 nA fel- Butler -Ged s 1122 <br />Au ust 2 1986 s <br />TN. <br />�) A N npNOUNCeoo <br />..August 5, ° 2 <br />`,� wr,- ,A.q•A.w aw-r.r. -d-�wtr/MrM � "��, w�..�ii <br />,� o..M11••I.A .. r � <br />��' -.I rte. � TN.Il.'MY+• Mt <br />f Qm CQUMW A 11 IM r riM) <br />- T - - <br />26b. AUG 1110. <br />(*"If* T lN/! /01 t•/. 11 MM..•1 b.••11� .�..I 1M ; <br />VA 10, rQ . Iw.-r Mws.►....r..A 4.w <br />A3 A CON MYINC! For <br />L L <br />L_ <br />