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<br />200304861
<br />STATE OF NEBRASKA- DFPARTA4Ni OF HEALTH AND HUMAN SERVICES FDIANCE AND SUPPORT
<br />VRALSTAuWo(s
<br />CERTIFICATE OF DEATH
<br />IEDLx NNAML Elxsr MIDDLE - "Al
<br />11,
<br />DAIFYT FArx AWARI., UARA
<br />Merle James Stevens
<br />Male
<br />February 11, 2003
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<br />Grand Island, Nebraska
<br />IRS) .75
<br />Ma 3, 1927
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<br />508-32 -8972
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<br />me: 2111 North Park Ave.
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<br />Yvonne Harris
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<br />'Utilities & Water Dept.
<br />City of Grand Island
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<br />NAME T ATELL 1ART
<br />MDTREP MIDDLE U ITED sLeNnME
<br />W1111am F. Stevens
<br />Florence L. Burk
<br />u6 AxM FO FOW:FE? I1, INFCPAUNL.NAME
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<br />o, un1 m195 war w eareadnmcval 1/ /1953 5/22/1953 Yvonne Stevens
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<br />PM2111
<br />North Park Ave., Grand Island, NE 68803
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<br />FebA.E 15, 2003 -
<br />ClIFITERYOHCnEM . rOnv War
<br />Armada Cemetery
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<br />A L NAME
<br />CEMETERYORCHEMATDPY LOCATION CITY OR TOWN S—E
<br />ApfellAButler— Geddes
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<br />Miller, Nebraska
<br />F NLHAL II A REAR IsTREET OR RED. NO. CITY OR 7D N. BTAiE, BPI
<br />u1123
<br />West Second, Grand Island, NE 68801
<br />IMMEDWTECNEAE INTER Oxv OxE CAL 6E PFE LINE FOP IA IS AND loll Inlenal m,nn Seel ene eeeln
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<br />Cardiac arrest unknown
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<br />o nDERESS OF CE IERIPHYGICIAN COHONERG PHYSICwx nR DnuxTV ATrDeNEV 1 ITEM S REV
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<br />Sgt Edwards, GIPD, 131 S Locust, Grand Island, NE 68801
<br />xe41pI HAP
<br />DATE FIIED fiY PEGIGTPPP IMa D.Y YrJ
<br />FOR VITAL STATISTICS USE ONLY
<br />Place .......... ... A. ..... ................... B - .......
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<br />Reject
<br />Ira A- FAA ..".. nn LA. DNA P..,A
<br />I HEREBY CERTIFY THAT THIS IS AN EXACT PHOTO —COPY OF THE ORIGINAL
<br />FILED WITH THE BUREAU OF VITAL STATISTICS IN LINCOLN, NEBRASKA.
<br />Gn ",w ���
<br />APFEL — BUTLER— GEDDES FUNERAL HOME
<br />GENERAL NOTARY -Stale of 17 ka
<br />III RAYMOND A OSEKA
<br />My Comm. Exp. NOr, 27, 2003
<br />IL __TMV - ..........
<br />.........................Census Tract No.
<br />DEATH CERTIFICATE
<br />
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