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<br />89--- 104560.
<br />` WHEN THIS COPY CARRI:,S'•THE RAISED =4i. OF 'THE NEBi4ASVAi TATE-
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BEidW TO BE A TRV8 •COPY
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE TEf'� * , -;., . H
<br />BUREAU OF VITAL STATISTICS, QHICH IS THE LEGAL 2A _
<br />VITAL RECORDS.
<br />F CE
<br />O ISSUANCE
<br />.. '`
<br />DATE I S All _ _•: r�; : ,�;
<br />JUL i 1 19&9 .1
<br />sTANLEY 3:S_q : �4!�PEli•F :•�1tRECTbA
<br />LINCOLN, NEERASCA BURE4U -OF � *0`:'S$'I"*TI6TiCa
<br />East 7.5 Feet of Lot 2, and hest 41.5 Feet
<br />of Lot 3 of Buenavista Subdivision in the
<br />City of Grand Island, Hall :TanOSNMMVAM OHL%Lm -
<br />County, Nebraska CERTIFICATE OF DEATH th
<br />1 Oaclam • 11Aart fast Oki ZZ77
<br />7'Stlt. A urli -Of OEATM Awwk OR, YAW)
<br />Jay Wayne Malcom
<br />itdle. July S .1989
<br />a ►Tea AAIY »ulA.Awone,M fR- L,IIaTt1/, OA
<br />scaTeal N SaYgl IMT
<br />Wood .•Count • Iowa 74
<br />September 9, 1914
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<br />b nwA or TN ' Clark . a £A O,+aaan 0004 .
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<br />! alY. TO*"ON LOCH TH r I![10! UI,Tf
<br />)Srrcb Ij„tAAI
<br />SO ew""T►o,
<br />St. Francis Medical Center
<br />grand Island es
<br />Hall
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<br />Hall
<br />Grand Island 312 E. Dodge St. .6880 Wo
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<br />,Afll�l.tlalM : , . rsaaT tnpD.6 LAST f •AUT,wI. /YKT IAOOI[ T'w -.
<br />Robert Foster Malcom Grace Mary Thomson
<br />� Arta ofCIAtYEOa MY Or0flCSi' /!
<br />NOrMAMT NAIa llal,lP ADfMl Ji �ST»[aT OA ItrO MO. cITY p1TOlMl STATE. jl�ooi •
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<br />Jul 69 1'3489
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