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WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE <br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A TRUE COPY <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMENT. OE,HEALTH <br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL D$POS=RY, <br />VITAL RECORDS. ,.Icl ._ <br />DATE OF ISSUANCE <br />DEC 16 10 STANLEY %,- Ce00PER, DIREOOR <br />LINCOLN, NEBRASKA BUREAU OF ivt' ,rStXdf�TICS <br />J. <br />200210140 <br />STATE OF NEBRASKA— DEPARTMENT OF HEALTH <br />BUREAU OF VITAL STATISTICS <br />CERTIFICATE OF DEATH _ <br />OlflDf N} -MAILf f1115} MIDIXE wsI <br />SEX <br />A Eq DLaN (MO.. pep Yr.1 <br />I Donald Olin Walker <br />D. Male <br />December 3, 1987 <br />]. <br />MCf 1 WbiM1, el•,L A en OIGIN /DfsCf 1 ".IMII n. ADS yer UNpE1 I YEAR VNDIR 1 DAY DATE Of BI t rM IN <br />Ivd k)!Sp•eilZ1 Arne N.IIS ill lYn.l MOS. DAYS HOURS. MINIS <br />White <br />5 American b" 78 Bd. October 1 1909__ <br />IF' A.DSIAIE O1 BIR1 (I Tin LLS.A., CITIZEN Of WHAT COUNTRY MARRED NEVER AUAFF D, NAME Of SIO11 S!(Il..E.. y:.• mm,N. ­W <br />r•1 <br />w rp1 WIDOWED. p IVORCED(Sp•nlvl <br />Albion, Nebraska U.S.A. <br />• 4 ID. Married a Bonnie McClure <br />...... <br />SOCIAL SEC WIM1 NVMBER VSVAI OCCVIATION (L;e Sind a /�etl don•doriny RIND OF BUSINESS OR INDUSTRY COUNTY Of DEA}M <br />niotl <br />el_e.5iey rM...•enrN;..m <br />464 -0 En sneer <br />Ix. u. ub Railroad 14 Hall <br />CITY, IOWNOR IOCATIONq DEATH INSIDE CITY IIMIii <br />NOSPIIAIOIOTNNIN51I1",ON- Nem•Ill nelin •iMO. I, NOM OR mN. Ldr <br />ISp•ril YFF er Net <br />Grand Island des <br />Div°It—, and —I-) d^nrNnrltn•r s.r.ven•alic•rHtl <br />Im IN. <br />Aa "S[. Francis Medical Center IA.. IEL atient <br />RESIDENCE STATE <br />COUNM1 <br />CITY. TOWN Of LOCATION <br />SRFETANDNUMEFR <br />INSIDE CITY LIMITS <br />Is.. Nebraska <br />ub Hall <br />rx. Grand Island <br />Ise. 1021 S. Vine <br />Isp.dr r,,. Net <br />f.fiXFR -NAM NIDOLf AST <br />_ <br />MOTHER - MAIDEN NAME FIRST MIDDLE LAST <br />I Cecil P. Walker <br />17 Gertrude NMN En.gleman <br />_ <br />WAS DECEIS'D EVER IN U.S. ARMED fORCESf IMIORMJNi- NAME- fEAUOraSXlp - MAILING ADDR[SS ryneN OR.Mp. rvO OM1 OR UI Ie <br />Ur... v.X 111 -1 ave r°I Ur.m.I ,x�n <br />2 <br />le. No ----- -- I?Ronnie Walker (Wife 1021 S. Vine Grand Island <br />BURIAL, Crenmiee. R•neval DATE CEMAFRY OR cNIA TORY - NAME IOCATION CIT OETOWN STATE <br />VD." Burial 2.IDec. 5, 1987 xk WeetlaSdn Memorial Park Dm. Grand Island. Nebraska <br />E FIG SII NSf ;S fUNFRAI NOME NAME ANO ADDRESS 15111[1 OR U.D. MO V" OR TOWN IIATI 1111 68801 <br />FA <br />122 . Livingston- Sondermann 505 West Koenig, Grand Island, N <br />- <br />AT .1 IN(Me., Dep YOI DA IONED I. Dep Yr,1 IxOUf Of.1.1. - <br />3 DecmFber 1987 <br />n N. we. x.e. M <br />OI _ <br />DHE SIGNED (Me., Dep Yet ROVE OF DNTN Stt IRONOUNCEDOIAp PRONOUNCED DEADIMeur1 <br />Pd <br />Pig i rAEe <br />s?d 7 IMCrmbel 1x987 8:01 <br />Jb xN a^ , x1,. <br />1 1 .•e.r e.a°I°rr°a s' <br />n•.INM.I m.r d•ror• p0 <br />Ef <br />vuMJ rnM.nv MrbeO <br />0. e1 •ren:n°rvma .°pin <br />' �N r— d— °.a <br />.Lr...a <br />x]a.lsi.n.wn.Nl:xNSN' i.°a:e..r°n xN► <br />N1Mf 1N0 ADOffS CERIIi1P 11YI COpNfRY I 51 I.N Of COVNIY Al10RNEYl llv °• °r Irinrl � - <br />)<] S. F. Nabity, M.D. <br />P.O. Hcx 550 Grand Island Nle. 68802 -0550 <br />- <br />DAIR RECEIVED BY Rf G15}p.R (Ne, Oop 1r.1 <br />aee.ITY -1°I ►_ <br />xeb DEC 1 0 1987 <br />_ <br />1 >. INMEDIAiE C SE (ENx[R ON ONE CAUS[ IFR 'IN' bf (vy (b). AND (rp T <br />PART n on u.n o.a a.e <br />'Q"'ul l <br />a <br />DUE IO, ON AS A CO^NSI.UNCF -- —� 1 o" x <br />IN � <br />DUE TO, Of ASA CONNSE�Q�UENCE OF, ." a_. <br />i. <br />l-1 ~L <br />l.V- ✓`f'e� ~i J� �. /. <iy <br />/hOCw� <br />1.1 /T •n <br />YMe <br />IA., ... I'S• MTICNS- <H:�r:°mrw�m�!�.rvy5ryu'ro+ee`r'xYe. En,S AS AIOr wAiurrnf5i0i�RED10 C 5 <br />!G INMeDRe A <br />It rA51 NIx51 6 »ra, 6rs ° E ORONRR <br />YLONna� --e- <br />�O lSpR1I, .N N rvN <br />•• � N_e ❑ ID �pN <br />_ <br />.40wC10l Uxpl, Ep�wulY /.xw D.r : Wwlwuq 1MOw IWVRV IX[ V OED- <br />C <br />w rwwxe mnsn TWN.ISr•ery/ <br />J� <br />bbRY.l <br />01 Mw •. m•.r. r.r °.,.]W.. <br />b°IILnI w p•.7 <br />WEADOry SIEfE1 pRR N. VnwlOwx 51 <br />A D x AlE <br />W, <br />X <br />BY <br />