|
D
<br />O
<br />D
<br />1
<br />M
<br />M
<br />T
<br />N
<br />n
<br />G
<br />n
<br />M
<br />WHEN THIS COPYCARRIES THE RAISED SEAL OF THE NEBRASKA HEALTHAND HUMAN SERVICES
<br />m
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTICS SECTION, WHICHIS-
<br />n
<br />n
<br />DATEOFISSUANCE r/�
<br />APR 12002 200206579 ASSISTANT�LTTEREGSTRAR -- -
<br />LINCOLN, NEBRASKA HEALTHAND HUMAN SERVICES SYSTEM
<br />STATE OF NHHRASKA, DEPARTMENT OF HEALTH AND I DIAIN SERMMFWPNNCE AND SUPPORT
<br />vr,O.ETVvaV 'ti _ �J
<br />2
<br />x
<br />n
<br />J J
<br />IE,
<br />Sharon Kay Falk
<br />Female I March 13
<br />2002
<br />�o�
<br />c
<br />I
<br />IL,ynch Nebraska
<br />m
<br />to
<br />Oe Lober
<br />18 ,Pa 1943
<br />s ooasswJA.. xuuo_x
<br />�.s,s, � su
<br />HPIOPITAL ::1 N oIN" n ..— ...
<br />506 -56 -6809
<br />TT
<br />n
<br />z
<br />❑ ❑
<br />n
<br />x
<br />St. Brancis Memorial Health Center
<br />❑ ooA ❑
<br />�,. ,owx asu IITiON O, NI -
<br />m
<br />couNT.oTO.°rN
<br />Grand island
<br />El
<br />Hall
<br />n
<br />n
<br />z
<br />° --
<br />n
<br />cv
<br />N
<br />o
<br />0
<br />N
<br />y
<br />F3
<br />N
<br />WHEN THIS COPYCARRIES THE RAISED SEAL OF THE NEBRASKA HEALTHAND HUMAN SERVICES
<br />SYSTEM, IT CERTFES THE BELOW TO BE ATRUE COPY OF ME ORIGINAL RECORD ON FIL €WITH_
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTICS SECTION, WHICHIS-
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS.
<br />DATEOFISSUANCE r/�
<br />APR 12002 200206579 ASSISTANT�LTTEREGSTRAR -- -
<br />LINCOLN, NEBRASKA HEALTHAND HUMAN SERVICES SYSTEM
<br />STATE OF NHHRASKA, DEPARTMENT OF HEALTH AND I DIAIN SERMMFWPNNCE AND SUPPORT
<br />vr,O.ETVvaV 'ti _ �J
<br />2
<br />5 Q 7
<br />0
<br />CERTIFICATE E OF DEATH
<br />J J
<br />IE,
<br />Sharon Kay Falk
<br />Female I March 13
<br />2002
<br />�o�
<br />III
<br />IL,ynch Nebraska
<br />I IT- 58 11.-
<br />Oe Lober
<br />18 ,Pa 1943
<br />s ooasswJA.. xuuo_x
<br />�.s,s, � su
<br />HPIOPITAL ::1 N oIN" n ..— ...
<br />506 -56 -6809
<br />._ °PN '
<br />❑ ❑
<br />m ,."I T. N— ;r...,,,., �o..9,k,.... b,.,,.,M,...,
<br />IN.IT .,, a.e..,.
<br />St. Brancis Memorial Health Center
<br />❑ ooA ❑
<br />�,. ,owx asu IITiON O, NI -
<br />1N i ear iwTS
<br />so�rN
<br />couNT.oTO.°rN
<br />Grand island
<br />El
<br />Hall
<br />Nebraska Hall 'I 1 11 A,0NIeT
<br />Whit o m., .....„
<br />uses 000uP.noN ;o�...,,N...n o-m
<br />.mM,nnr.;
<br />w.w..gmm +�. w.Mmi P u�
<br />?iscal Secretary Fee
<br />IIIIER VI "III Nin
<br />Irvin
<br />.INOeC.n, I I.. ,,.,.,.V -LI..
<br />803 © N
<br />Grand Inland 3532 Schroeder 6 ve.
<br />11 ©wNAAiEO Owioawen- �- �Meo,svou �r«m.
<br />° � nNEVER rl IT OAC, James R. Falk p tl
<br />ws�
<br />SOode[ Helco Krugman _
<br />Mr. James R. i+alk
<br />3532 Schroeder Ave., Grand Island, NET 68803
<br />,Me . PPIENO yj T� , o.TE Yoe
<br />❑ (March 16 2002 Hillcrest Cemetery
<br />oaTON
<br />Apfel- Butler - Geddes ❑a•'^'°^ ❑ ;�. c,MS„AroH CHEUA•uNorfolk, Nebraska >,s
<br />INE VNEML MOVE ANZIIII ISVetT OA IT m xu -I IOn Tnwx PLAie. ZIPS
<br />1123 West Second, Grand Island, NP:. 68801
<br />IIIRT
<br />EI
<br />SI S
<br />CNIE TV QR AN L .:�.Ii err.,
<br />oN�TOS w wAA�AOEA.EOW. YVI L_ IT ❑ , ai n N. r�
<br />�,xP. �. axNx,�wx °, ��NE.��NAxP.o�_ °° n
<br />N.
<br />o N; , ITT z
<br />FE
<br />T
<br />III,/ /3oZ p �l /c /Z III IP
<br />I h s
<br />ff . _—
<br />IN VI17FENTINANT.1
<br />E ,sP P.
<br />S; II< Coy
<br />fie`a -r--nT iizJere M.P. 2116 W. Faidle Ave.,_ Grand Island E.
<br />su ��EasTxAN zw u°T'Plo
<br />I'll IAR 2 is.xu� 8 ,„ N.,.,;
<br />W1 2002
<br />w�
<br />
|