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<br /> i�3EN '.['��S �4PX- C�RAIES�THB� �ISED SEAL OF THE NEBRASItA STATE
<br /> OEPAiRTMEDiT ,OF �lLTH,:•IT CERTIF2ES THE ABOVE TO BE A TRT3E COPY .
<br /> OF AN ORIGIHAL RECORD ON FILE f�1ITH TNE STATE DEPARTt�iENT OF HEALTH,
<br /> BUREAt� �OF �IT11L STIUTISTIC3, WIiICH IS THE LEGAL DBPOSITORY FOR
<br /> � V,ITAL REG'OItDS. .
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<br /> � . i ssued Oec. 28, 1984 _ ,_----=_
<br /> DIRECTOR, 9ULtEAU OF VITAL STATISTICS LINCOLN, NEBRASKA
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