z =
<br />w
<br />(Z �V
<br />N p
<br />RE"
<br />1
<br />xo
<br />n ,
<br />EE
<br />� al
<br />N
<br />O
<br />s
<br />rD
<br />Q �
<br />z i
<br />a a
<br />xo
<br />6
<br />Y
<br />n
<br />C1
<br />3
<br />7
<br />9
<br />Z
<br />O
<br />K
<br />A
<br />uw]
<br />m
<br />M
<br />a
<br />rr
<br />2 > V1 CJ
<br />(y1 O ti
<br />= n en
<br />CXD
<br />� ~
<br />� �A o
<br />rn v? m
<br />N O
<br />WNEN Tips COPYGR%ES RIE RAISED SEAL OF THE NEBRASKA HE,
<br />SYSTEM, RCERIMS THE BELOW TO Or TRUE COPY OF ME ORK
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL ST
<br />THE LEGAL DEPOSITORY FOR MTAL RECORDS.
<br />DATEOFISSUANCEx_ -,u� AKLEY g, COOPER
<br />10/15/2004 2004107 A8BTSu1�ANT dTOERE01SrRAR
<br />LINCOLN, NEBRASKA HEALTRAND,WAKANSERWCE$SYSTEM
<br />STATE DP NEBPA5IU- DEPAATMEM DP HEALTH ANDINMANSSSVICESFYaANESANO SUPPORT;
<br />04 11113
<br />•• • •• , l.s*
<br />]. sEx -. -' a oAreca LFUx Iw•n. rear wX
<br />Hxsl wox.E
<br />Female October 9, 2004
<br />Lillian Sean Sprague
<br />Iiv AUOSrniLill rn ro'X1!Sa. nrm wWrl Ec nGE. W1BmWr unceRl`FFP'
<br />UxoEx aWiEVEgRix II4.aal Ny. vwl.
<br />,. nm w. was. onus
<br />'-
<br />x.NaRrm
<br />November 5, 1933
<br />Hastings, Nebraska 70
<br />OCW SFLUPLIY NU— ea. MLECF OGiN ® xv
<br />❑ apaoya rryXanv
<br />506 -46 -1355 — ❑ ❑ w,a„„
<br />mPPCllm.x.x. alalawNm m+a.w awwxan F;+Ga,WMx
<br />❑
<br />❑ mP ay�lvanx�
<br />Tiffany Square Care Center
<br />rtv. iowx oR wcN.nx of ouiN ce IuacearcuNns e.. counrrerouiN
<br />Grand Island x•+ ®x° ❑ Hall
<br />9e'°
<br />_ RR RRY7K xMUacnirory P1. srfCETnnU NUM B pwNWVN ttJaI nEGly uMxs
<br />W. couxlY
<br />®"°❑
<br />wNebraska
<br />Hall Grand Island 2506- Sothman Dr. 68801
<br />a
<br />E.I.ask aNR. Mxmn,Men. 11..WLETPV I.g. aaax w.InnOmmenwl ®Il•APMO 2 ❑m EoF FPLUSE'p M.Rw m,N,na xl
<br />la xLeIVy
<br />wllsaaNl IRmM - xEVEx GrvEO SPYagLLe
<br />White American
<br />la wo 1 E m"
<br />auw4OELUPniKK, IWafMaavN M'eM'V' of eusWESa IxCUSiPV 1 ouWibx ISa✓M xR0!+x +re Wxm
<br />0
<br />bweachePni,A O.Ia E•I
<br />'rage eats
<br />Teacher Public Education _
<br />wwFx su
<br />• Ex FlWi m'a'IE
<br />Ia. FATHER. —I
<br />Kalber
<br />Karl Tows Be
<br />lxryECFAF£L EYFP PCESt
<br />as oa
<br />lac INFORMIxINw
<br />µl rvri..e.:wveevn °isrcewl
<br />Leroy Sprague -
<br />wn woREea - IsileEi cPRF.o. xe.,cmwiowx. siarean ' -
<br />FOPIMNI Mx '
<br />2506 SothmanoDr., Grand Island; Nebraska 68801
<br />NSE XO. 1a ME1HW OFpW I1MN 4o E a1, Go,E A vlawEwicRV xWaE
<br />`Oct.
<br />yE
<br />p
<br />❑RN,aaM 14, 2004 Parkview Cemetery
<br />cEHrePYVR G vCniGWN aria
<br />E Mas!w, v!Nebraska
<br />EuxEMI NPME v
<br />❑ ""'°" ❑°vi HastiLPn
<br />Livin ston -Sonde rmann F.H.
<br />Va ISixCF?OPPF.O. NO -Qiv CP iWIH. SirtcEW
<br />601 N. Webb Road, Grand Island,Nebraska 68803
<br />I Ymrva av W.
<br />EGJ,SE IExIEx OUt CPUSE PFA u104 M'Obll
<br />'YP' IvluM. ! HwJUewnmxiiaurean
<br />T. o.OPM PCWI OF.
<br />Y � �U{E�N{6
<br />lel IWU • •E]O� !P� N4 al
<br />weio, on ASnwxsEnuExcEOF'.
<br />ul PARrmI nE xa ♦ Er E Oio MFLGK
<br />VLi1EF SICwFx urtcoxorcloua .C°vnwmuW'NgX x.Eawbina Waal OR CORONER?
<br />iHEPMid axA^IniX91
<br />yuro—�
<br />PnPi ppEOxul
<br />Y luy,l ealx Yu
<br />zm.
<br />zc. onlsoE lx✓uxv rw.oa. nl
<br />x.- HwRO!�H,uRV
<br />xa oESCE.E — ROMCURREO
<br />umroma�.e
<br />R
<br />El area x ��I
<br />❑ 5 as L, Panr'v
<br />Pao-
<br />p' yyA�mo1ww
<br />'u e�p- akRY l%w'WI.IUmWM.MM
<br />'.E9. LLCA1'. r PEEi CA0.Fc. XO. iYdiOWN s1.rE
<br />❑ 14n¢ a im®getim
<br />Yn ❑ Ho ❑�R
<br />,-
<br />GATE Wo EC Wp. wl' -✓!I 3W. nME OF UFAiH
<br />itCfCFAIN Iai1 �- ✓/U
<br />X'o ^October 9, 2004 3g
<br />zie ilMe OF OEAM z &. PWNUUxcfo Ail rMx: wr. vl ]&I. PRDHWxc[OUEPO llml
<br />nn 11TE1E1 11 -1 . v,l
<br />05:30 P.;I. 6
<br />9 are.x�.,.aamnnn,rw.a°°a.e,�awx
<br />w.Miwn
<br />a °a xaroarewew .am :axre.l..Mw.e.,.newl.,mm,aaa.
<br />Ertl W[aW W.b PemwlatlYal.
<br />x
<br />°auoH.l,wrt
<br />�f�
<br />i�r�w"- -rere.wr
<br />nwaawnaEln sx.xiecP
<br />�a µxEfAXiPoBViEiV MFCF Wa0P6AN�iISSVF GnniCH PEEN LONSIOFAE %w ''11 G%I.NO
<br />xGOioLLna � W o NNKWL ❑ YEF ❑ .EE YY
<br />al AxooPEESLF LFPPFRA rvxrecwx, cOWNFAS PHVSI:'ux oHCOUnirnnawEn nro�Mal
<br />E oaDr.
<br />Anne K. Ma se, M,D., 72 N. Custer, Grand Island, NE 68803
<br />A MiEF4E09v HEGIFIPPA rMa. Ca✓ ✓.l
<br />Gai OCT 14 2��
<br />
|