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WHEN THIS COPYCARRIES THE RAISED SEAL OF THE NEBRASKA HEALTN ANP HONMNSERVICES
<br />SYSTEM, ITCERT ES THE BELOW TO BEA TRUE COPY OFTNE ORIONIALRECORD'`ONFSE= r
<br />THE NEBRASKA HEALTHAND HUMAN SERWCES SYSTEM, VITALSTA TISi7CSSECLAlN IWIIONIS
<br />THELEGAL DEPOSITORYFOR VITAL RECORDS. -/ -
<br />DATE OF ISSUANCE jl
<br />JAN 2 5 2002 3 All TE R
<br />ASSISTANT STATE REGI$TTRA$
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<br />WHEN THIS COPYCARRIES THE RAISED SEAL OF THE NEBRASKA HEALTN ANP HONMNSERVICES
<br />SYSTEM, ITCERT ES THE BELOW TO BEA TRUE COPY OFTNE ORIONIALRECORD'`ONFSE= r
<br />THE NEBRASKA HEALTHAND HUMAN SERWCES SYSTEM, VITALSTA TISi7CSSECLAlN IWIIONIS
<br />THELEGAL DEPOSITORYFOR VITAL RECORDS. -/ -
<br />DATE OF ISSUANCE jl
<br />JAN 2 5 2002 3 All TE R
<br />ASSISTANT STATE REGI$TTRA$
<br />LINCOLN, NEBRASKA 2 0 0 3 0 3 4 5 3 HEALM ARD IA WtN RmAaIE3Svsr®ii
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