o�
<br />C b
<br />M s � v
<br />C On m o
<br />N O N o O
<br />Fn
<br />n 2
<br />W N CJ
<br />N
<br />�
<br />W v
<br />r
<br />W N W
<br />N
<br />rt
<br />MHENTMSCOPYCAAWSTHERAISED SEAL OF THE NEBRASKAHEALTHAND MJ RWgRWCES
<br />SYSTEM, RCERnFIES THE BELOW TOM A TRNECOPYOF THE ORIGINAL RECORD ONflM4gTH
<br />THE NEBRASKA HEALTH AND HOMAN SERWCES SYSTEM, WEAL STATIST1CFSBC?MwWHRXKIS.
<br />THE LEGAL DEPOSITORYFORWTAL RECORDS.
<br />DATE OF IS
<br />AUG
<br />200210088 As e
<br />—R-
<br />LINCOLN NEBRASKA HEALTHAND FIfb1fAN SERWCES_SY$TEN
<br />N �
<br />STATE OF NEBMSKA. DFPARTAIENT OF HEALTH AND MIMAN 8111@"M MILNCEAND_$UPPoRT
<br />Y TAL STATISTICS
<br />CERTIFICATE OF DEATH -- d
<br />.00ZE ., -. —_-
<br />Darroll R CncK male 1yO 21A
<br />+ r s M ...
<br />s s s
<br />4 and Ielantl, Nebraska 7�Or.E June 5...1929____.
<br />E, OF DEATH
<br />Hl IRUA
<br />500 30 2523
<br />_ _ EO, re.�
<br />.St
<br />Francis Medical Center O
<br />-__.-
<br />AN IT, Q)GNTN1L,' T Ill OT HEATI
<br />Hall
<br />Island ® ❑1_
<br />_Grand _
<br />G AFAIIFhLF T_ —_..._ N a s, ei A NUMBEa i.. ° ° „o : °..,,., cos 11 T,
<br />Nebraska Hall Grand Island 2222 w,Forrest688031L�
<br />c °r<
<br />white S AmerTCan ep Dorothy Haile
<br />,y
<br />w..N
<br />owner
<br />A TURN "A FlPBr MOO,E LnS MOmEA nmi MiW,F wi0Em9UPUnrzE
<br />Ho D. E ck M rtle I. Heins
<br />EEO Dorothy =nck
<br />__
<br />Ill QA....T RATING ADDRESS s IEEF ON N.,. ryJ OT1 ON QANN SATE ON
<br />2222 Forrest St_ Grand Island, Nebraska_ _ 68803
<br />—
<br />51, J ALIN I IN Ill DATE -.- ��
<br />(% © N. - Id u I 2 20001 Grand Island Cemetery
<br />Is ENA�NOM . N
<br />All Faiths Funeral Home ❑ m'"°' Grand Island- Nebraska
<br />Q— FALL AOO +da F—Al ON IF O NO_O. ON STAN. STATE Zin
<br />S. Locust St. Grand Island Nebr..
<br />68801
<br />=c.O�SEoLsNebraska _
<br />PART
<br />IAR.�iKS
<br />-
<br />DUE TO OR AS A EaxseoUENGE GE iNA,IRI MARE.,, F,„,,.,, ._.
<br />,A.
<br />y 21 HLIFELD1 I "111 11
<br />5
<br />CL ❑ , ❑O ...
<br />_(�
<br />IQ,
<br />- . .m A.a°,. -STRAIT .o _
<br />� Al �,..,-
<br />III 2A LOGGED IS, 1, r,. MEGFONATH
<br />Jul 21, 2000
<br />k Ill FAIR ISSFID 1. AR, .,I TMEEEGU,. �s ITUNOUNGmoFAO .DUE . afiOA) sno n—
<br />�A
<br />,x rT'. JU1V 26, 2000 AM a
<br />° AS °,. °45
<br />„ °, «.W..
<br />looIN
<br />� — emp —IO,D amANO.N,
<br />segA-I!,
<br />i6 F •AE
<br />ROAD CO USE CONTRIBUTE TO E LD1 u E G A r.
<br />❑ vrs IVI NIA
<br />UAOiNUfJ a v, vsc ANC 5 Nv5CU.0 *v ITT "FAR vrvw 1,1
<br />William J Land'S 2444 W Faidle , Grand Island NE 68803
<br />FEGisRna GATE FRED IF REGISTRAR
<br />2000
<br />W JUL 31
<br />LEGAL: LOT TWELVE (12), IN BLOCK TEN (10), IN COLLEGE ADDITION TO
<br />WEST LAWN, IN THE CITY OF GRAND ISLAND, HALL COUNTY, NEBRASKA
<br />
|