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<br />STATE ,00 NEIORAOKA
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTMENT OF lali
<br />THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD ON FILES WITH THE -
<br />HUMAN -SERVICES, VITAL RECORDS OFFICE, WHICH IS THE LEGAL DEPOSITORY
<br />DATE OF ISSUANCE
<br />06/1212015
<br />LINCOLN, NEBRASKA P
<br />STATE OF NEBRASKA . DEPARTMENT OF HEALITH AND HO
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