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<br />(me., D.r. rr.)
<br />1. Theodore NMI Vanosdall
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<br />NAME p S•OUiE /N.dle, B:.e tw:d... weAte)
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<br />WIDOWED. DIVORCED (SOeci/r)
<br />,o. Married
<br />In Brown
<br />SOCIAL SECURITY NUMBER!
<br />1:.508 -07 -6264
<br />V ` Z
<br />1KINDOFOUSINEMORINDUSTRY
<br />Vanosdali Sanita
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<br />COUNTY OF DEAT"
<br />,... Hall
<br />Cm, TOWN OR LOCATION Of DEAT"
<br />I .Grand Island N-h ka
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<br />HOSPITAL OR OTHER INSTITUTION - N.we (N A« is eiMet,
<br />B:w IPieN ew1 we-6er)
<br />Lutheran 114e.
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<br />RESIDENCE -STATE COUNTY
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<br />I,.. Nebraska 13.. Hall
<br />liscGrand Island
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<br />David W.
<br />1>
<br />WAS DECEASED EVER IN U.S. ARMED FORCES?
<br />(YK r. - —6) 1 IN Tee. p+ wr ewd dw- .1 to—ca)
<br />III. No
<br />INFORMANT- NAME - RELATIONSHIP - MAILING ADDRESS (STWIT OR 2 D NO. CITY OR TOWN, STATE, ZIP)
<br />IrHelen Vanosdall wife 319 E. 11th Grand Island Ne.
<br />BURIAL, Ct.- skew,
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<br />22Apfel- Butler - Geddes 1123 W. 2nd Grand Island, Ne.68801
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<br />WHEN THIS COPY CAMWS THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SERVICES
<br />21e.
<br />PRONOUNCED
<br />2
<br />i Is 6 0.
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<br />v 2N.
<br />(M.. Der. rr.)
<br />216.
<br />HOUR OF DEATH
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<br />SYSTEM, R CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD -9N FILE WITH
<br />HOUR OF DEATH
<br />123c.
<br />DEAD PRONOUNCED
<br />DEAD (How)
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTICS.SE£T�OK*4cH IS
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<br />Aw E eN _ uw c P PMY_ uw tlR [ tftlwTV Annewtcrt
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS
<br />DATE OF ISSUANCE
<br />n.— — e,:.n
<br />ALEIES�O�R
<br />NOV 6 2001 200111415
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<br />A Sm A�vr i7fR_#GISrRaR
<br />LINCOLN, NEBRASKA HEALTH AND H SERVICES SYSIEfW
<br />STATE OF IMORASKA— DEPARTMENT OF NEALTH
<br />MUM OF VITAL STATISM 83 03347
<br />CERTIFICATE OF DEATH ►/..; �3
<br />-
<br />(me., D.r. rr.)
<br />1. Theodore NMI Vanosdall
<br />Male
<br />March 4, 1983
<br />RACE - (.•B -. Wulf. EIERd, A-«icM
<br />Iweiew, Mr)(S► «iII1
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<br />ORIGIN /DESCENT(0.D..Ieii•w,Mwicow. AGE
<br />O«yw. Mt) (SI«ill) rrn.l
<br />6 e,.
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<br />UNDER T TEAR
<br />UNDER I DAY
<br />I DATE Of ENRr" (me.. Dsr. r..)
<br />,Februa 11 1893
<br />MOS. DAYS
<br />eb. Es.
<br />"MRS . WNS.
<br />AM iA of BIRT" t-P i. U S. -A., CmiEN OF WHAT COUY.TRr
<br />. N R MARRIED.
<br />NAME p S•OUiE /N.dle, B:.e tw:d... weAte)
<br />ww ts..A•
<br />Greeley County, Nebras U.S.A.
<br />WIDOWED. DIVORCED (SOeci/r)
<br />,o. Married
<br />In Brown
<br />SOCIAL SECURITY NUMBER!
<br />1:.508 -07 -6264
<br />USUAL OCCUPATION (Giw kmd ol-" eewe 4—" -oo
<br />ef-eriitgtoo ifmOk")
<br />(,..Owner erator
<br />1KINDOFOUSINEMORINDUSTRY
<br />Vanosdali Sanita
<br />„b.
<br />COUNTY OF DEAT"
<br />,... Hall
<br />Cm, TOWN OR LOCATION Of DEAT"
<br />I .Grand Island N-h ka
<br />INSIDE Cm LIMITS
<br />(Speei/)rY« «Na)
<br />I4. Y m
<br />HOSPITAL OR OTHER INSTITUTION - N.we (N A« is eiMet,
<br />B:w IPieN ew1 we-6er)
<br />Lutheran 114e.
<br />M NOSP OR TNST Iwlitot. DOA.
<br />•er R• . 1wP•"e•t rs.«•r)
<br />RESIDENCE -STATE COUNTY
<br />Cm. TOWN OR LOCATION
<br />STREET AND NUMBER INSIDE CITY LIMITS
<br />I,.. Nebraska 13.. Hall
<br />liscGrand Island
<br />Ise. 319 East 11th ;s° lee « "•)
<br />FATHER MIDDLE Vanosdall"'
<br />MOTHER MAIDEN N A ME FIRST Au um
<br />David W.
<br />Jesse L. Hove
<br />WAS DECEASED EVER IN U.S. ARMED FORCES?
<br />(YK r. - —6) 1 IN Tee. p+ wr ewd dw- .1 to—ca)
<br />III. No
<br />INFORMANT- NAME - RELATIONSHIP - MAILING ADDRESS (STWIT OR 2 D NO. CITY OR TOWN, STATE, ZIP)
<br />IrHelen Vanosdall wife 319 E. 11th Grand Island Ne.
<br />BURIAL, Ct.- skew,
<br />20e urial
<br />mb. rch 7, 1983
<br />CEMETERY OR CREMATORY -NAME
<br />eat United Methodist Cemetery
<br />LOCATION Cm OR TOWN STATE
<br />2w.Greeley, Nebraska
<br />f— Afl RE R POSE �t/ t
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<br />FUNERAL HOME —NAME AMC ADDRESS (3TnET OR R.I.D. NO.. CITY q TOWN. STATE, 11ry
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<br />22Apfel- Butler - Geddes 1123 W. 2nd Grand Island, Ne.68801
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<br />PRONOUNCED
<br />2
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<br />(M.. Der. rr.)
<br />216.
<br />HOUR OF DEATH
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<br />DATE SIGNED (Me.. Dey, Yr.)
<br />27►. / J� `Q� 25 rN
<br />HOUR OF DEATH
<br />123c.
<br />DEAD PRONOUNCED
<br />DEAD (How)
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<br />Sheridan T. Anderson M.D. 1811 West Second Street Grand Island, Nebraska 68801
<br />REGISTRAR _ DATI,R JqIVID BY REGISTRAR (Me., D." Yt.)
<br />26e.ftiswwr..l���f�/
<br />r P AU !ENTER ONLY ONE CAUSE PER LINE FOR (s), (b), AND (c)) 1.%-1 ►eh— _w ..d bed,
<br />DUE TO. 04 AS A CONSEQUENCE Iwwt..ol ►olt.oew eftw .wd de.IA
<br />(6)
<br />DUE TO, OR AS A CONSEQUENCE p: IwN.wl ►Mwew «t.t .w1 I.oIA
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<br />PART S— Cood6"wt c"WI..d., N I..M ♦.1 wM r.I.%d PART IR. If flMAl! WAS TNEn A AUTCMSt WAS UK n /!ERlO ro ME01CAl
<br />R MEGNANCY IN TNT PAST 7 MpiT"sT (SP.tifr Y.t ) [IfMMMER W C R
<br />Y" O No C 2R. 29. ( 7
<br />oR�rEiloN+o wrESnwnoPi rsr«+r) .
<br />wu11.T AT WOS I PTACE O. wOI-Y- A. bass, t..e, wow. I.tlerr, LOCATION ST4ET OR e. F.D N.. CITY OR TOWN STATE
<br />fsA.tdr Yw W MO) oNis 6• wR. eft. ,span/,)
<br />70.. 701. Ms.
<br />LEGAL DESCRIPTION: Lot Two (2) in Block Thirty (30) in Russel Wheeler's Addition to
<br />the City of Grand Island, Hall County, Nebraska.
<br />
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