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V� {x/ <br />hF VAR <br />v <br />a <br />WHEN THIS COPYCARRIES THENAISED SEAL OF ME NEBRASKA HEALTHAND HUMAN SERVICES <br />SYSTEM. IT CERnFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD ON FILE WITH <br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STA77877CSSECTIOMWHICH IS <br />THE LEGAL DEPOSITORY FOR VITAL RECORDS <br />DATE OFISSUANCE OO <br />200204938 IATAEY$COOVSR <br />^11fp` 18 20U2 NDHOANTSTAWCESS3TRAR <br />LI C LN, NEBRASKA HEALTH AND HUMANSERVICES SYSTEM -- _ <br />STAn0FREBMS1(A- nFaaxn mxr orlffAl.lH ANn xpMAN SaRmcES }a+AHCC,wusuPeoar 0��� <br />vnALSTAnscc^ 02 9 <br />v <br />Sioo.E <br />m <br />I D 2 <br />O,nxvx. 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'1' <br />�x� r.OxEr E.rx <br />aFTF DIET- <br />Grand Island <br />� "° ❑ <br />c, <br />T <br />O ° <br />o <br />0 <br />PIS <br />Hall <br />Grand Island 3211 Mem <br />his Place 68803, X❑ x +❑ <br />00 <br />m <br />T Z <br />INC) <br />Cr . <br />s m -b,.n <br />American <br />EESSE n <br />m� <br />SAxx <br />.�xOO� oxsxESS xwsm sonrv.+ <br />EOUCA *�+E�.r128x mi.ao'.us <br />.wcrv..awa.+•.w„'- <br />n usu¢OCCxPA x <br />r.,..m.,n e, min <br />a.s..v.o..,.F <br />r <br />Sugar Com an aas +- 11 A-HER <br />Altred R• <br />Smith Monica <br />. Bigley <br />N <br />ixEOVU.x,.xm, <br />IVVn w nx n a 5 d ^r^,I <br />Yes � A9 -25- 56/9 -27 -60 <br />Elnora Smith <br />CO <br />CJ <br />O <br />n <br />C0 <br />W <br />Lot Eight (8), Block <br />Two <br />(2), Colonial Estates <br />Tenth Subdivision <br />in the <br />City Of Grand Island, <br />Hall County, Nebraska. <br />WHEN THIS COPYCARRIES THENAISED SEAL OF ME NEBRASKA HEALTHAND HUMAN SERVICES <br />SYSTEM. IT CERnFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORD ON FILE WITH <br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STA77877CSSECTIOMWHICH IS <br />THE LEGAL DEPOSITORY FOR VITAL RECORDS <br />DATE OFISSUANCE OO <br />200204938 IATAEY$COOVSR <br />^11fp` 18 20U2 NDHOANTSTAWCESS3TRAR <br />LI C LN, NEBRASKA HEALTH AND HUMANSERVICES SYSTEM -- _ <br />STAn0FREBMS1(A- nFaaxn mxr orlffAl.lH ANn xpMAN SaRmcES }a+AHCC,wusuPeoar 0��� <br />vnALSTAnscc^ 02 9 <br />v <br />Sioo.E <br />__....- -_.AS. <br />s O. +oE.xN , —wY YFA <br />EFOES <br />O,nxvx. EASE <br />Alfred Thomas <br />Smith <br />Male <br />_April 14, 2002 <br />N8 UFF <br />AAA <br />iw. <br />FT, OF ... 11 =r n.o <br />sFebruary <br />.w�..xO ,ArE Or ei,,,r romAO.+. ,�.., <br />ws w <br />FIRE <br />Z 65 <br />19, 1937 <br />Grand Island, Nebraska <br />ocSE SE�uanv xOSEEa <br />x <br />❑ TAA.AI L1.0 <br />man EAmA <br />36- 4183 <br />❑'FOAV— <br />❑ S. „a.., <br />❑ <br />X507- <br />IN a F -x,.. m�wwm.., mK,x«i.,Ae.x.�wn <br />❑ m. <br />qnx rsar'x _ - - -_- <br />St. Francis Skilled Care <br />- <br />u C111 T5 On.00AxoE OE Oe: *� <br />_ Oec *. '1' <br />�x� r.OxEr E.rx <br />aFTF DIET- <br />Grand Island <br />� "° ❑ <br />-. - <br />s. s E "- m cwE,. <br />E <br />x c rnr a s *S� .E iOEOx..iai.s <br />Hall <br />Grand Island 3211 Mem <br />his Place 68803, X❑ x +❑ <br />Nebraska <br />. <br />' �,......,.. m„ Axc .x,. S....na NSARIEO ❑vn- <br />s e.. 1 <br />s m -b,.n <br />American <br />EESSE n <br />White <br />SAxx <br />.�xOO� oxsxESS xwsm sonrv.+ <br />EOUCA *�+E�.r128x mi.ao'.us <br />.wcrv..awa.+•.w„'- <br />n usu¢OCCxPA x <br />r.,..m.,n e, min <br />a.s..v.o..,.F <br />Factory Manager <br />,nrAFD EASE S <br />Sugar Com an aas +- 11 A-HER <br />Altred R• <br />Smith Monica <br />. Bigley <br />E EAEE�EVUV'uSM O/A—AN <br />ixEOVU.x,.xm, <br />IVVn w nx n a 5 d ^r^,I <br />Yes � A9 -25- 56/9 -27 -60 <br />Elnora Smith <br />Ix.oES." +3211 Memphis Place <br />Grand Island Nebr <br />SEo EFULATURI <br />Not Embalmed �❑ ❑ A <br />ro.EEEaA ou NAME <br />-^ - - - -- I ., © =..N ❑ <br />601 N. 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