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<br /> ' • � SxATE DEPAI�TMENT OF FiEALTH, IT CERTIFIES THE ABOVE TO BE
<br /> f ���1 TRUE COYY• OF' AN ORIGINAL RECORD ON FILE WITH THE STATE f
<br /> ;. � y�EPAR1'HE:JT'OF' HEALTH, BUREAU OF VITAL STATISTICS, WHICH i
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<br /> • : j I ; LINCOLN, NEBRASKA Issued t�pri 1 29, 1981 _
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