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<br />WHENTHISCOPYCARRESTHE RAISED SEAL OF THE NEBRASKAHEALTHAND HUMAN SERVICES
<br />SYSTEM, RCERTIFIESTHE BELOW TO BE ATRUE COPY OF THE ORIGINAL RECOROONFILt -WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTICS SECTION WHICH IS
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS. I O
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<br />DATE OF ISSUANCE p
<br />JAN 112001 aoc? o Tl5 a9 STATEANLEYS, COOPER
<br />ASSISTANT STATE REGISTRAR
<br />LINCOLN, NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM
<br />STAIITOFNFRKASKA- DEPARTAtEMOFIffALiNANDHUMANSQIVIC FlN CIiAM)SI MRT
<br />VRAL STAMUCS -- - '
<br />CERTIFICATE OF DEATH
<br />Fc.D_„T NmnE 'IT M FF .,AlT .F. DITI 01 DUTR da.N ... T"'
<br />Clarence Joseph Fiedler (Male December 29, 2000
<br />I" 1` A ., ..a„
<br />Lexington, Nebraska I;0 E'ebru dry 9 1920
<br />PLAcEOFOEIIH
<br />SO6 16 8404 °` Z ETEII
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<br />Card Samaritan Hospital w " C ° -
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<br />Kearney. Nebraska
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<br />Nebraska Hall
<br />a. W NA LJ Buffalo
<br />OP LOCATION 9d. STREET AND NVUBEE -F,Gy Z"tau. 1e IlEl LRY LIMR6
<br />Grand Island
<br />E_..° White —, American
<br />L6L1AoCCDPATIOA eamn no..., . n KIND OFRI
<br />(11 nec� &FOperator Clock
<br />FIIH R TAME FpVT A111,1 LAST
<br />Joseph Dennis Fiedler
<br />- ,tL 3'
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<br />I. W Charles 68801 A.. ® A. ❑
<br />D�oacw Julia Klauz
<br />Daphene Hagadone
<br />1 1021 West Charles Grand Island. Nebraska 68801
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<br />WHENTHISCOPYCARRESTHE RAISED SEAL OF THE NEBRASKAHEALTHAND HUMAN SERVICES
<br />SYSTEM, RCERTIFIESTHE BELOW TO BE ATRUE COPY OF THE ORIGINAL RECOROONFILt -WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISTICS SECTION WHICH IS
<br />THE LEGAL DEPOSITORYFOR VITAL RECORDS. I O
<br />f
<br />DATE OF ISSUANCE p
<br />JAN 112001 aoc? o Tl5 a9 STATEANLEYS, COOPER
<br />ASSISTANT STATE REGISTRAR
<br />LINCOLN, NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM
<br />STAIITOFNFRKASKA- DEPARTAtEMOFIffALiNANDHUMANSQIVIC FlN CIiAM)SI MRT
<br />VRAL STAMUCS -- - '
<br />CERTIFICATE OF DEATH
<br />Fc.D_„T NmnE 'IT M FF .,AlT .F. DITI 01 DUTR da.N ... T"'
<br />Clarence Joseph Fiedler (Male December 29, 2000
<br />I" 1` A ., ..a„
<br />Lexington, Nebraska I;0 E'ebru dry 9 1920
<br />PLAcEOFOEIIH
<br />SO6 16 8404 °` Z ETEII
<br />- ❑
<br />Card Samaritan Hospital w " C ° -
<br />yprvTOWNOaLOGnUNJFTtn irvamL O,rvumrG xa 'OUrvTY OF DEATX
<br />Kearney. Nebraska
<br />sd
<br />Nebraska Hall
<br />a. W NA LJ Buffalo
<br />OP LOCATION 9d. STREET AND NVUBEE -F,Gy Z"tau. 1e IlEl LRY LIMR6
<br />Grand Island
<br />E_..° White —, American
<br />L6L1AoCCDPATIOA eamn no..., . n KIND OFRI
<br />(11 nec� &FOperator Clock
<br />FIIH R TAME FpVT A111,1 LAST
<br />Joseph Dennis Fiedler
<br />- ,tL 3'
<br />"Yes WW1 7 "218 7 399/4 -5- 1945'"
<br />9"NFTRMANT nnauNO.h,vE,. s"'Ell OEaFI rvo aP
<br />I. W Charles 68801 A.. ® A. ❑
<br />D�oacw Julia Klauz
<br />Daphene Hagadone
<br />1 1021 West Charles Grand Island. Nebraska 68801
<br />W11 ,: ❑ "m�.a Ol 02 2001
<br />Westlawn Memorial Park
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<br />Apfel Butler Geddes ❑ - °" " "' Grand _Island:
<br />Nebraska
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<br />1123 West Second Street rand Island, Nebraska 68801
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<br />8 L.. Steffen M.D.- 211 West 33rd, Kearney, WE 68847
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<br />LOT FOUR (4) AND FART OF THE WEST NINE. (9) FEET OF LOT THREE (3), BLOCK Ii,
<br />BOEHM'S SIIBDIV ISION TO THE CITY OF GRAND ISLAND, HA1d, COUNTY, NEBRASKA.
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