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<br />wNW IM4COPYCARRIES PE RAISED SEAL OF n/E NEBRASKA HEAUHAND HUMAN SERVCES
<br />SYSTEM IT CERTFES TTIE BELOW TO BEA TRUE COPY OF THE ORK7I RECDRFi ON FILE WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL S_F41 T7YiTOS'K. WINCH IS
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS.
<br />DATE OF ISSUANCE
<br />4/17/2003 COOPER
<br />ANTSTATZ REGISTRAR
<br />LINCOLN, NEBRASKA HEALTH �,�NSYSTEM
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