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WHEN THIS COPYCARRIES THE RAISED SEAL OF THE NESS
<br />SYSTEM, RCERTFlES THE BELOW TO SEA TRUE COPY OF
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM,
<br />THE LEGAL DEPOSITORYFOR VITAL RECORD&
<br />°4 /18 /2003 200402353 XAM
<br />ASSISTA
<br />LINCOLN, NEBRASKA HEALTH AND HUM
<br />STAn OF NF9RA .DIOFe Ta AND sl]NAS SM
<br />VITAL STATISTICS
<br />vir aT nF1 VaTT]
<br />SUPPORT
<br />03 04263
<br />I. DECEOFNi.NANe Fllisr "IOOLE lA5 *'
<br />I6Ex
<br />0, DATE OF DEATH /MwNr ON,. DW
<br />Orville Archie Lembur
<br />Male
<br />A ril 5 2003
<br />Lm axG 6iALEOF BIPiN lXmnUSe. mmemawry
<br />s.. eel Elm,ew
<br />NOEP I'eR
<br />OEPIUKI
<br />IT, OFeIPiN LLbM Ott Veal
<br />mE DAYS
<br />sN xouR6' MINE.
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<br />February 16, 1926
<br />Y
<br />Rockville, Nebraska
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<br />z.EnYTow"EDLOC <nGN OF DEATH HIX I.YU * OFAiN
<br />Omaha Y. "•W❑ Don las
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<br />1710 S_ Blaine Street Grand Island Nebraska 68803
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<br />2IJ. LEME]EPY OPO OxVLOla11M CrtV OPYOWx STATE
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<br />Kleine Funeral Home " ^"'°' ❑1e'" Gibbon, Nebraska
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<br />3213 W. North FYont Street, Grarrl IslaTrdX Nebraska fiRA03 _
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<br />YN DATE OF DDRID INK NY. Yr1 - WTL6 NE0 NNBY„ W FwEDFOF.TH
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<br />❑ YES R NO VES ❑ W
<br />❑ YES ii ED ❑ U"..,
<br />XAMEAHOAUOPESSOFOFMIFIE"IPHY6 MN. DOPONEP'6PHYSICNNOHWUNWAnOPNEYI INN RWl
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<br />WHEN THIS COPYCARRIES THE RAISED SEAL OF THE NESS
<br />SYSTEM, RCERTFlES THE BELOW TO SEA TRUE COPY OF
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM,
<br />THE LEGAL DEPOSITORYFOR VITAL RECORD&
<br />°4 /18 /2003 200402353 XAM
<br />ASSISTA
<br />LINCOLN, NEBRASKA HEALTH AND HUM
<br />STAn OF NF9RA .DIOFe Ta AND sl]NAS SM
<br />VITAL STATISTICS
<br />vir aT nF1 VaTT]
<br />SUPPORT
<br />03 04263
<br />I. DECEOFNi.NANe Fllisr "IOOLE lA5 *'
<br />I6Ex
<br />0, DATE OF DEATH /MwNr ON,. DW
<br />Orville Archie Lembur
<br />Male
<br />A ril 5 2003
<br />Lm axG 6iALEOF BIPiN lXmnUSe. mmemawry
<br />s.. eel Elm,ew
<br />NOEP I'eR
<br />OEPIUKI
<br />IT, OFeIPiN LLbM Ott Veal
<br />mE DAYS
<br />sN xouR6' MINE.
<br />yf
<br />February 16, 1926
<br />Y
<br />Rockville, Nebraska
<br />77
<br />1. EOCVl9ECVPiIY NUNOEO B• PLACE OF OFAiH
<br />jj IKNIM OEIVE ❑ N Hx.•
<br />508ry3F0 2756 �p
<br />_.. ❑ EP ONPw, ❑ H« ..
<br />.m. "- EDKO.,,wM». ON —KIN —)
<br />mVA
<br />❑ DDW ❑ oNel
<br />Medical Center
<br />w muxry OF
<br />z.EnYTow"EDLOC <nGN OF DEATH HIX I.YU * OFAiN
<br />Omaha Y. "•W❑ Don las
<br />a.FEVOEXLE -STATE cauxlY Y Lm. TOwx OR LOLAnp1 YEDW7.DNOMPEP I4Whp2IK. sIDECm uMrts
<br />wv
<br />Nebraska hall Grand Island 1710 S. Blaine /68801 ® N. ❑
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<br />U`SWL OCCUPAiWx lnreuWdeux mn Prlgmw, KIND OF -.
<br />MmN.IVw«...n>r,N . el
<br />Farmer A iculture
<br />MWFdo2M12I
<br />Mu0EU 6uPoUNE
<br />A xAM FFLi
<br />Harry John Lembur
<br />Laura Helen Carstens
<br />_.
<br />FAEED EVEP1x V5. AP O mROa?
<br />Ifl WA 1eE
<br />DC
<br />_
<br />I" -NAME
<br />�} FOPMVIT
<br />nw.x•,"` m'r"e-- •�"MJ.M.mw..Nw
<br />Yes Korea /1DRDOU - 12 -18 -52
<br />Delores Lembur
<br />_.9 -
<br />M wsOxunNi MNNW AWPES'i I6iPEETdPFO. W.CITY OxiVarN..iaiE 9%
<br />1710 S_ Blaine Street Grand Island Nebraska 68803
<br />t]. EM6LLMEP � SIGNniUPE a YORK. NO r°uEIIpOMLVSFOYTXri 210. SIU CIRRIEPV OPCVtxaTORY- NAPE ru'erV1Ce
<br />Z ❑6�xM ❑P«.°NI April ''14, 200 Central Nebraska Cremation
<br />2IJ. LEME]EPY OPO OxVLOla11M CrtV OPYOWx STATE
<br />�6 A
<br />Kleine Funeral Home " ^"'°' ❑1e'" Gibbon, Nebraska
<br />2a. FU NEPALMMEAOO"E66 ISIDEETORR,ERO.. P1YOHTOXN, STIDE.LPI
<br />3213 W. North FYont Street, Grarrl IslaTrdX Nebraska fiRA03 _
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<br />P'
<br />Respiratory Failure Mnuees_N1.�Ja..m
<br />N,
<br />UUE I O.OH A6 AOOxFEfuFALE OF
<br />Pneumonia /Sepsis _ Days
<br />IN _. __.
<br />DUE TO OR/u9ACP LOUENLECF.
<br />lamb Bleed Days
<br />HEFFRAFOroMEDwP,
<br />s �CNNnlmeemvlNWgm WJwp�OMMis'me F YFlM1F. WASTI utt]P6Y 'A^a g1ONEO+
<br />TEl w
<br />GFILAHTCONDITOxO
<br />p 1NE PP4!] E nwxFA
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<br />O5•WM m
<br />O pµ 1 261.PA•C OWF�UU_ It rompflN n'e N.Er, 3s %LCCATNn. STREADH NSG XO. CITV ON TGWx REATE
<br />At
<br />HNN- I:F,WDN :oTe0
<br />YN DATE OF DDRID INK NY. Yr1 - WTL6 NE0 NNBY„ W FwEDFOF.TH
<br />April 5, 2003 . M
<br />6 _ GED OPA 2wP
<br />M DATEOENCO I-wY I,, — V,T Yxe""'I O1... m,. Y,l mxouxeeD DEm 1-1
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<br />°al.FKNJ , ^!/f
<br />IF IDI max•NTBIe P ✓V/�V I6 mwm rNTN P
<br />M1`M6ENT❑G
<br />2B DID TODAMIDIIEECONTXAVTEI -HE DEFY III I HAS gWFN OR TSWL YORNTION BEEN IDNEDIVIED ? W +S. PANTED?
<br />❑ YES R NO VES ❑ W
<br />❑ YES ii ED ❑ U"..,
<br />XAMEAHOAUOPESSOFOFMIFIE"IPHY6 MN. DOPONEP'6PHYSICNNOHWUNWAnOPNEYI INN RWl
<br />NY
<br />Bonnie E. Nowaki. M.D. VA Me ical_Cen r W y aa.N 68105
<br />Fn vNEGISrMP I
<br />HEDIGxM DA wL_ 6 APR 1 N' II
<br />V
<br />Lot Twelve (12), Block TI c (2) , West Pal Air Addition to the City of GraAdJi�UA,)
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