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WH�N TFNS COPY CARIZIIES THE RAISED SEAL OF THE NEBRASKA HEALTH Al��.�It1t►C�8 SYSTEN�IT CERTIF�S THE BELOW TO BE A TRUE COPY OF THE ORIf31NAL l�.__ � THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM,VITAL STAT/STl�-_ _ 4 ��-_� THE LEQAL DEPOSITORY FOR VITAL RECORDS. _- F 1 U - ��== = 9�b�1°2� 1'� � �: _ Ass�sr��r� .__ UNCOLN,NEBRASKA HEALTHAND Hi11� �_ -_ �"�.�': � 99 111359 -- -�-- _=_ �.� STATE OfS�RE�AU OF YITAI S�TIST�CS ��TN . CERTIFICATE OF DEATH 9 5 -�0 6 0 5 7 � oetmerr-ww[ �� rowE us� � s�c �W TE OF DEAtN ,uc.�s�n+r r.rn _ Doris Margaret Johnson Female May 24, 1995 •.Cm'MO41AtECi�1M Ibwl�SA��LOnIW ('� Sa AC.E-WBNWM UNOERtYEM . UNDEp�Wv 6 Atl st ,� DW�+Nrl London, England �'J ""' bg �"'0`;a�5 x"°�'+s �' g 1926 7 90i.M1 SEQA1tM Ml1iEP d oIAC!OF OEAiM� . . 508-30-4933 «o�TU ❑ �+.r OTNfF � W„�.p�. __ ❑ �"o„�.�„ � "..,°",�. �t.ta,tv-Mr,. II ror.....u,9......aro n.�e.? r� ❑ St. Francis Skilled Care Center �^ � °""' S°"" - �c at.�aw w toc�t�a+a oFwn� ea MsroE u*r irurs ne cow*�oF o�� Grand Island ,,„ � ,� � Nall y�11ESOFMCf•SIAiE �COtXITr 9C CIiY.TpIM/ONIOCATIpN !0 $IREEiANDNUM�BLN MMdrqIOLu�I 9e M�SDEGTYtIYM15 Nebraska Hall Grand Island 620 West Avenue 68803 �«� �,❑ ,o n��wc-w�...s+n�«.�wa.� �,.�siav�.o wn.w.�.c«�.k� �:�wuw�o �woov+FO �3 w�ert or sva�sF �..r•o.+�•�^�»r "" `�`�" American �jl. ��EA o�EO Marven Johnson {�i t e 15 EDULATION �so.�.,aw�••��•��^� 14 USIUlOOCUPATION �c�...vd.wm.�.a..+v� �.e�woaeuswessr+ouslpr d�a�9M�wwi/riM�e4 ��w �p� Er^w�+;Y�fS�conerr�0�71 CarW��as•� Checker � '� Grocery Store �� tb i�T11ER.N1IME iF57 MKKxE U57 17 MOiMEP iIRST 11�DOlE W�OENSUPNAME Harry Nr4d Douglas Lydia N1�V Bushell 1!W�5 DECfASE�E�EN M US ARMEO�ORCES? �9�M�O�T�N4ME 1�'w.ro.av►.1 �MN�►P�w��o1�� Marven C. Johnson tye MFOPYIIM yAllyp�pp�$$ �51REElORRiD NO pT�'�iOMM SI�tE ZMI -- 620 West Avenue, Grand Island, Nebraska 68803 __ zo •s�c�utu�a uc�ra a+.uern000�o�sv�iro�. t+e ate a�c CEUE7EarONCAFU�irJwr wurt � . eZl.C�lr�'�//43 �e,.w ❑w�.y May 27, 1995 Westlawn Memorial Park ^ 7+a CE�EiERrO�+C�Ewrq+r�OL�r� cn.cx+tov� STAtE 7?s FIM�ENAI NOME�NAME Livingston-Sondermann F.H. ❑°'"'°" ❑`A"'°" Grand Island, Nebraska , np F�ME11K IqME ADp�E55 �S1pFE1 O(1 Ri.O NG Gry pq TpAM S��TE.21Pi � 505 West Koeni , Grand Island, Nebraska 68801 ______._ IENTEH ONLY ONE C�l'SE PEp LINE FOR�a�iE!ANO icll � ��Y��°°~w':M'�� n� rwrEpATEC � ' vw+t ^ K .J � S �c_. `-iC?��.�.�a�1M°'� 1 iN � rr.y oewse� n�vw.w,. . pUE TO.OF Ai A CANSEOUEtiLE O� � ID' ----.--,- .— - --—v+el.aio-www�m+w.m�r.u� .. OuE TO OA AS A CMSEOVEMCE O� ' � n _ � —T�uTOPS. 15 W�5 c'�SE WEFEwED rU u[t7�C�u ��q . 5. fneae ��e1�N l �.. �VN�ETGN HLY�P�S1�MO�IiMS� E%AMINFRMGONOtikN'n v,w - �.nl� �JkS ��M�s+o-sn r.s ra �v.. r+o Y^_11.�"_°J.fll_- ,.. �, � wre os �w aw v,� � �ouaa w,n�r xa nESCan�Now�.�um occu�+eo n4cb.. U ll�'�Oa�e�'� � M � �� -... � �a D pryq 7� py�/wr►7WO�IM 7N PIACE��p�'�.1�^^��Y �9lOCAT10N S/REE7pRRiDNO f,ilrpqTOWN St��E a�t � �b�.[s Y�r�yqM��^ vw� No O ____.-_. 2!i [MTf S�GMEO lW QiY Yr I ZBD TM1E OF DEAT� T7� DAiF Of OEA/M ;1b:.in r�I s3 � Y MAY 24 1995 S='�' M-- '71t Tt44 Of DEATH 'X g' 2E( P�INLED DEAD �Mb aMV.Yrl �EG FAO�M7JN(.CU DEAD llkvi �f �an a.r[s�cr+eo ,w o..•,, ��< -- '—"-- rr��k MA: 26 1995 � II:OOa,. E�� E� 2M O�v�e owa o1�u�w�»m a�a a+rv�sp+b^.n my opn�a�wan uccun�o m ^' 770 1 J Ae tMf t/�^P�^�r+4'q�aa/�ott V��U�1 M Mv. O�s b kM tit Mrr.J�M nM O�e YV aue b N Ca�eeltil SWM �'� (� �j �-�_ _ .�...�. .�,.» �� pp O��p.rr+9uiEtOiwf�iM psMASORG�NOAT15SVE0OM�TDMBFENCANSI0EAE0'� 79DW�SCONSENTGRAH7ED� .ES ❑ NO � IM�NOwN y � KS � � Y ❑ YES ❑ � -- .n � 7� NAME�NO SS O�CENTiIEP�iwrSKAAN.CONONER 5 PHYSILNM OR CQMtV�T70NNEYi ��rW n R ?� W.J. LANDiS, M. • 4 �AIDLEY GRAND 1SLAN E 68803 ___ ]A O�TE�IIEDBrAEf,�STF�w �Mn.WrY�1 �.��.� � rt . ��n� 21995 Lot 'Itaelve (12), West Heights Second Addition to the City of Grand Island, Hall Cotmty, Nebraska. �