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t, <br />u1+++141"N 3i <br />} <br />z 31 <br />a <br />ffM Y <br />r 1 <br />la <br />i.. <br />t <br />1td>,4 <br />tOn ii <br />YI!"' <br />sta.il,d6 <br />4 <br />etv <br />v4000$44 <br />`is?(it <br />.0A00.0, <br />1 <br />t A . rl 11;0010,00),, <br />n 1 1 1 11 <br />d 4 1 I >• <br />1 ) 1 1 � � <br />Ilii t � <br />1 / �% Irl i \ i� <br />0 1 1 1 <br />Q r I r ( I <br />I r r. � 1 l <br />I )- t,.� ( t 1 11�a rl <br />.+ I QQ pp in �� ��i!qq��.sI.F.MI..d,,,5eZ5sh[ngd.lailQ,)�ul.+eR�ih6...a»a�.S I I ,��Bn.r <br />.:rd1�1�111111E1 ��+n3,5li+td+�'i)�,. w'Y99 i/LAJ. � `a � f�,r <br />(5.1; li 1 11tdd43dtdru+�Ir rrdrON0 due <br />STATE OF NEBRASKA <br />•,rrrgrgqtaNa„was �rY9l'111r1tff31.a> rir4li!1Pldrd , �rori114.7i1.rPltDlet:s. <br />Ila,` <br />iffic <br />F} , <br />.etiq`$ <br />SS <br />bb'l�)t <br />iNM1Irier, <br />ii,+lYt` <br />Nt1:Ei <br />4,401 <br />WI11EN H/v COPYC CR 1ES`THE RAISED SEAL OF STATE OF NEBRASKA, 1T CERTIFIES THE DOCUMENT BELOW TO' <br />13E A 71 UE COPYOP hE ORIGINAL. RECORD ON FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND: <br />HUMAN SE • RVICES, VITAL RECORDS OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS <br />DATE QF ISSUANCE; <br />11/16/2021' <br />LINCOLN, NEBRASKA.; <br />202300486 <br />SARAH BOHNENKA <br />ASSISTANT STATE REGIS_,_ <br />DEPARTMENT OF HEALTH <br />AND HUMAN SERVICES <br />STATE OF NEBRASKA - DEPARTMENT OF HEALTH AND HUMAN SERVICES <br />CERTIFICATE OF DEATH <br />1 DE P.ENT'S NAME .(F ret Middle, Last, Suffix) <br />David Walter Mc ,argue <br />4 CTT'f AND STATE QR>TERitITORY; OR FOREIGN COUNTRY OF BIRTH <br />`central City, Nebraska;; <br />?,SOCIAL SECURITY NUMBER <br />508 52 427 <br />2. SEX <br />Male <br />21.;1524$: <br />3. DATE OF DEATH (,Mo„ Di <br />Oc ober;2112. 21 <br />6.: DATE of BE2Tlt(Mo:, NOW, <br />February 22 943.. <br />6a A'GE Last Birthday: <br />(Yrs.) <br />8b, FACILiTY;NAME i(f rrot Itlatitution, give etr <br />1821 bel Mar Circle <br />8o2CiTY OR T0WN:a <br />+vrarld laiAtld <br />and number) <br />.DEATH (Include Zip:Code) <br />9a. RES NCE.$TA1E`; <br />t�iebraska' '. <br />d srR TANDNuMBER',.. <br />1621 Dal Mar Circle' <br />1GaAlfltRi7A(« <br />Married, but se <br />1 <br />9b. COUNTY <br />Hall <br />Sb. UNDER 1 YEAR <br />Sc. UNDER 1 DAY. <br />MOS. <br />DAYS <br />8a PLACE ODEATH <br />HOSPITAL ❑ Inpattent. <br />ERIOu patient <br />❑ DOA <br />S AT TIME OF DEATH ® Married 0 Never Married <br />ed QWidowed. 0 Divorced 0 Unknown <br />FATHER B: NAME (First, ': <br />Walter Mc Harglte .: <br />te; .: ; <br />