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.. �+ .�.iy . .a. .. .. 0000. • - <br />. .....1 -.a � "p.:�+ R ' ?•- �rM.yaj�h{ty,�r.,].7,,r±•.t �.� •• ,-A *f��k_ ..��,r�._,i., .:u -. <br />,.....`......__......._ 0000 0000- .a...............- 00.00._. _. ... _._ x .. - - _ _ <br />1�/4 7i/•s �, -�.,' 1���,;�; r:oy -- 1gAly <br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE 900 / fG ` U ' <br />DEPARTHETIT OF HEALTH. IT CERTTFTRR 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 MPOSITORY M <br />VITAL RECORDS- <br />DATE OF ISSUANCE <br />. I •. ,aT,:c °'". . mil, , <br />STANLEY COOPER, DIRECTOR <br />LINCOLN. NEBRASKA BUREAU OF #;T%i§jATISTICB -- <br />STATE OF NEBRASUA— OEFARTMEMT OF HEALTH <br />BUREAU OF VITAL STATISTICS <br />CERTIFICATE OF DEATH , 80 10384 y ?:•;:'_'�: <br />-N.,y -- -- �1� ArgOA N oEA rAa., D.r• Y01 I . <br />Monica Acnets Furbv e 4 1 I30 <br />_p.D, Aaa1r11N OIpNE/OESClNTI•D. 11.4.w. n•.a/.... AOE— %"D.../w U 1 V wo , Mi-fAL•. AS". 1101 <br />Ia1�IM. MrJfsD•Ib! a ••k lfsr•I.EA 41-4) nos . OAri NOW3. wNS. <br />,. White erican 54 s Dec. 30 1925 ,. <br />A OI'EiM1N( asEM YIA, cmum ur VMNATC AMlrED. NEVEEMAEMED. "am of arm ( W10. ton -01N.some) rN <br />wtOOWEO.OWOECEDfsn•44 <br />• Ashton Neb ask C.S.A. i Married Elro E. Furb i. <br />mcummmomm UMMOCCYMtIDN(OM&.•IdwAN•.Iw��•M 11MrDaDUfINEifO/MWDET!► cO1N111aNAM -/ <br />of 1, 0 fik •r+11 it 0!1.11 T 111 <br />to 507 -24 -578 11. usewife 113► Domestic Hall <br />cm. iOWM pElOCA110N p DlATN 1NNum CRY LuWTi ""IT" as OMNI N11T1TU110N -IMaar (Y..•l a. N1Mr. M 1101. OE 041 1."wo DO& <br />fsr»s.lrr «r N•1 D"~&ftE.•.Md wti..+vi...r.r�•uwlrL.wM ' <br />Grand Island L•1. Yes Iw. Lutheran Melaorial HOS ital t Inpatient ). <br />DESIDSNCE -STATE COMMIT Cm. TOWN OD LOCATION 31EEETANDNLIAIOEE DENOECrtrLMUri <br />ff YAvumm <br />113. Nebraska ISd. Hall Tsl Grand Island f5/. 2124 W. 10th tE Yes <br />' A — LA1f N — tRST IAYD <br />Maximilian - Grudzinski Wlad slaw - Moraczewski <br />WAS DECEASED EVES IM U.S. MWO MKIST Nl10EAUM- NAME- EEI4fIDMSHI► -MAWNO ADWEm *Tastes SID No. cmORd'DLNIr�EEAt Jfm <br />..t frww.a WAS 111 tr• 0" 0.01 of Wr N VOsli <br />TE. No Ir Mr. Elroy E Farb - Husband -2124 W. 10tIn- IGrand Island NE. <br />wllElAl. c1•a•.�.••. ILp t:. 611 19 lMETEET <br />Of REM4Iblt -NAlAf lorAn9N CK1r.ODTOWN STATE <br />q....�I <br />sal Westlawn Iftnarial Park Izw. Grand Island. Nebraska <br />acb. B ial sad <br />0,000..•• '. 3WAlA E►t71 N0.�1� fuNE11AL HOME —NAME 4P9 44i7DEELf IEIMIt MDro No. CITY a 10MM, EtAtI EYI <br />EE.A el- Butler-: eddes 1123 W. 2nd Grand Island NE. 68801 <br />- • •4 ' - (' �' .� n IA• /W.I.1• W • • . r. M be* M 0.•..W.1.. -101" -T ••r•••+dm* • w"O'S M . <br />wM ` ! •M .�•. r•r r.1 N•.• w M u M• •ww.�r .MM <br />130.1 ../ I.MO HOMCWDU wdj 10U11 OF MATH <br />Q� � <br />Eab. - member 51 �Q 731. <br />i a aATe s 2. MO NOUNClDDEAD(Nwr) <br />Of S PWWWNEDDD <br />septenber 4 f 1980 <br />M <br />(M•. Der. Yr.) AS <br />q C Stl�lll INT3KIAN, C !S'f /NrfIC1AN W COON AtTOSNErI ITp. r /n.11 <br />E. A. Brulth M. D. 908 N. Howard Ave. Grand Island NE 68801 <br />EIVEaEr ISTRAE(M•. Day. 110.) <br />3...rw.M...1�• J /' /1i�..ut? ��C�:,��- C'-- C._. -�i' —A, - i r�r�'�. � %�'U <br />A :A{71T j I(NTEI ONLY ONE CAUSE PER LINE FOP (h). r T JWV (9)1 - ww.r.tLS.•. I..+rw1U <br />V <br />! ff. M AS A Mougmt Orr C r...11..1w•• ..1 A-N . <br />TO. W AS A COMMOUfMCE OF: r'�'•a °' <br />t — C�•1.1wa r M.. M.M• ►ut It 1/ p all, E 1.1I61rA11tT1 tt111T 11a..nr/• «M.../ iO �I C itY «MV/ « 24 1 VON •1 - <br />i a1CC1DIM, fU1CIM. 1N7MCIp. uMt111 . M"E d1 W 1 .O.O. r. , MOu11 p owuSr ISCO1411 mw IWysiT OCC1.911 <br />. { p tEND01a INr111MAT10N It••••4' <br />309 30b_ 1301 <br />IIUUST At MOLL IVLC10• ways. — •. 11.-...•.- +.w..irr./- lIXAloom 11Mt' U 410 W COST p TOWN STATE <br />im•..ry, ►« r a «a .11... a-IAM. 0" asn.eal <br />300, ]XII <br />1 <br />