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STATE OF NEBRASBA— DEPARTMENT OF HEALTH 78 0 3 3 7 4
<br />BUREAU OF STATISTICS
<br />200304043 CERTIFICATELOF DEATH
<br />NR1r MmDEE LA„ IsE. D
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<br />- ,. *E -oi
<br />MINS.
<br />_ Grand Island,
<br />1111AI 111NR11T NUMBER
<br />D,y, Y,I
<br />CITY TOWN OR D64CATION&FIDEATH 411.1 IIIY I IMITI , HOSPITAL OR OTHER INSTITUTION NA rr IA O fines r IF HOSP IF
<br />�(S and b J
<br />ISE Grand Islaxd _ fes�d.St _Nrancis_Hospital 114. Inpatient.
<br />�--RFSNENCE STATE Co NIF CITY .row V V oN 11X1[ No NUMBER s OE C r IMIrS
<br />rs , .�e, N,1
<br />I` ,S. a Nebraska b Hall I [_Grand island 15d.6ll South Washin ton e _
<br />r
<br />FATHER -E a.1 - E'IS' IE ST " 'morHER- mAIOfIJ NA 1r MIDDLE
<br />F ,
<br />Ernest __.. Reher. -1 -1 Wilhelmina Stoltenber_-
<br />w S UFCF D IN s A ED FONChs mANr E CAD o s M. N�. AO ss wEE CITY OR T6T8601
<br />u;c Wiili n Web ter Siusband -
<br />-6� ,`� 4l+.sh ngton .Grand Island Le
<br />rBURI L CRE mO D AT' CEMETERY O CXEMAIOXY Na O < OR TOWN STALE
<br />zoo Burial —Ji, bh ]o Grard Island (C1t;y� -- �d. Grand Islam_- 651101
<br />EMe 1 E - c E CE s 6l No E N ME NO IDDRES (STREET
<br />zI �� �• 12e�R Livinc, to7R N��ont3e moral s, SOS W noenihR Grand Isl and R[�e./
<br />DATE e ► sz I D�. `/� l�h Ll.� z r.. ► .a�.e.
<br />L'
<br />SI /ONE%O( - D r J No OF �E F D sG D( D Y7 lA
<br />6 1]]L l {. -,. 7.J ]. ) c ).... T IM Fi O _ _ m
<br />r R
<br />i V U1AD( r Ro OUNCEDDEAi, — --N u c OEAn OVOU VC[O DEAD �HOV 11
<br />" (. U,y )
<br />n'-1 �Y v.L /IS %L /(MI za _vim m
<br />.ME AND ADDRESS OF CURT F ER IvNYSIEI N CORONERS PHY5 C AN ON COUN Y E --YI lTyvo 11 FEET)
<br />r C Dean McGrath L. D., 729 SSo_rth (Taster, Grano Island lie, 68801
<br />�-&IRTRAR 1 _ ( /'Y/ ({ /�, //' T E RECC_EIVED E S MR M.M. D� Y J _
<br />�t6o MMLD Ai•AUSE �(F P NE CA FVfR (I' (F1 111, ANV I1)1 E6b' Fl�� ter. FVIb ���.vrl.
<br />EAU
<br />DUE i0/, OR AS A CONSEOVENCE ON rva
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<br />DUE IO, OR AS ACONSEW ENCE OI. u..a er...n amn entl tlmrh
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<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA
<br />-STATE DEPARTMENT OF HEALTH, IT CERTIFIES THE ABOVE TO BE
<br />.A.TRUE COPY OFI AN ORIGINAL RECORD ON FILE WITH THE STATE
<br />DEPARTMENT OF HEALTH, BUREAU OF VITAL STATISTICS, WHICH
<br />,IS THE,LEGAL- DEPOSITORY FOR VITAL RECORDS.
<br />O
<br />DIRECTOR OF VITAL STATISTICS AND ASSISTANT STATE REGISTRAR
<br />LINCOLN, NEBRASKA Issued Seplember 13, 1978
<br />The Southerly 64 feet of the Westerly one- fourth of the Northerly ore -half of
<br />Block Ten (10) in Wirrlolph's Pddition to the City of Grand Island, Hall County,
<br />Nebraska, as the sane is s=eyed, platted and recorded.
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<br />STATE OF NEBRASBA— DEPARTMENT OF HEALTH 78 0 3 3 7 4
<br />BUREAU OF STATISTICS
<br />200304043 CERTIFICATELOF DEATH
<br />NR1r MmDEE LA„ IsE. D
<br />� --
<br />- ,. *E -oi
<br />MINS.
<br />_ Grand Island,
<br />1111AI 111NR11T NUMBER
<br />D,y, Y,I
<br />CITY TOWN OR D64CATION&FIDEATH 411.1 IIIY I IMITI , HOSPITAL OR OTHER INSTITUTION NA rr IA O fines r IF HOSP IF
<br />�(S and b J
<br />ISE Grand Islaxd _ fes�d.St _Nrancis_Hospital 114. Inpatient.
<br />�--RFSNENCE STATE Co NIF CITY .row V V oN 11X1[ No NUMBER s OE C r IMIrS
<br />rs , .�e, N,1
<br />I` ,S. a Nebraska b Hall I [_Grand island 15d.6ll South Washin ton e _
<br />r
<br />FATHER -E a.1 - E'IS' IE ST " 'morHER- mAIOfIJ NA 1r MIDDLE
<br />F ,
<br />Ernest __.. Reher. -1 -1 Wilhelmina Stoltenber_-
<br />w S UFCF D IN s A ED FONChs mANr E CAD o s M. N�. AO ss wEE CITY OR T6T8601
<br />u;c Wiili n Web ter Siusband -
<br />-6� ,`� 4l+.sh ngton .Grand Island Le
<br />rBURI L CRE mO D AT' CEMETERY O CXEMAIOXY Na O < OR TOWN STALE
<br />zoo Burial —Ji, bh ]o Grard Island (C1t;y� -- �d. Grand Islam_- 651101
<br />EMe 1 E - c E CE s 6l No E N ME NO IDDRES (STREET
<br />zI �� �• 12e�R Livinc, to7R N��ont3e moral s, SOS W noenihR Grand Isl and R[�e./
<br />DATE e ► sz I D�. `/� l�h Ll.� z r.. ► .a�.e.
<br />L'
<br />SI /ONE%O( - D r J No OF �E F D sG D( D Y7 lA
<br />6 1]]L l {. -,. 7.J ]. ) c ).... T IM Fi O _ _ m
<br />r R
<br />i V U1AD( r Ro OUNCEDDEAi, — --N u c OEAn OVOU VC[O DEAD �HOV 11
<br />" (. U,y )
<br />n'-1 �Y v.L /IS %L /(MI za _vim m
<br />.ME AND ADDRESS OF CURT F ER IvNYSIEI N CORONERS PHY5 C AN ON COUN Y E --YI lTyvo 11 FEET)
<br />r C Dean McGrath L. D., 729 SSo_rth (Taster, Grano Island lie, 68801
<br />�-&IRTRAR 1 _ ( /'Y/ ({ /�, //' T E RECC_EIVED E S MR M.M. D� Y J _
<br />�t6o MMLD Ai•AUSE �(F P NE CA FVfR (I' (F1 111, ANV I1)1 E6b' Fl�� ter. FVIb ���.vrl.
<br />EAU
<br />DUE i0/, OR AS A CONSEOVENCE ON rva
<br />In ul hnWeen em. and tleaO
<br />NC-
<br />DUE IO, OR AS ACONSEW ENCE OI. u..a er...n amn entl tlmrh
<br />IT
<br />P ORRERN
<br />0 1 1
<br />]m. I BEET e
<br />cnoR TOWN IINTI
<br />!EP¢Iy YM,. N,I nv. e.aal.,,, •:�r.. -..r„
<br />]Oe. bl. ]V9..__
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA
<br />-STATE DEPARTMENT OF HEALTH, IT CERTIFIES THE ABOVE TO BE
<br />.A.TRUE COPY OFI AN ORIGINAL RECORD ON FILE WITH THE STATE
<br />DEPARTMENT OF HEALTH, BUREAU OF VITAL STATISTICS, WHICH
<br />,IS THE,LEGAL- DEPOSITORY FOR VITAL RECORDS.
<br />O
<br />DIRECTOR OF VITAL STATISTICS AND ASSISTANT STATE REGISTRAR
<br />LINCOLN, NEBRASKA Issued Seplember 13, 1978
<br />The Southerly 64 feet of the Westerly one- fourth of the Northerly ore -half of
<br />Block Ten (10) in Wirrlolph's Pddition to the City of Grand Island, Hall County,
<br />Nebraska, as the sane is s=eyed, platted and recorded.
<br />
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