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<br />Decorha, Iowa
<br />31..NAL/E AND ADDRESS OF MR IP "SICAK CORONER'S PHYSICAN OR COUNTY ATTORNEY) (TYDF O' Pr-V
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<br />E0. CITY. TOWN on LOCATION SO AND D MUMMA AW11 HF ZIP CN 11AKT5
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<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE
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<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A TRUE COPY
<br />IS; FATHER .NAME FIRST MIDDLE
<br />LAST
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMENT OF HEALTH
<br />Charles- -
<br />Kell 1
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITORY FOR
<br />t► WAS DECEASED EYEII !N U.S ARMED FORCEBT
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<br />Ethel Marie Kell 1��310 W. Division -Grand island,
<br />No
<br />20► BURIAL C11N1MO1LRwiwnM.' 104 DATE
<br />DATE OF ISSUANCE (�D�
<br />OOAMgn ,
<br />Cremation -Oct: - -1; 1992
<br />Central,Nebraska Cremation Gibbon, NE.
<br />JUN 81993 STANLEY S. COOPER, - DIRECTOR
<br />22 FUNERAL HOME - NAME AND ADDRESS ISTIIFT OR RF.D. Np, CRY OR TOWN. STALE. 21P1
<br />'Not Embalmed'-- -
<br />LINCOLN, NEBRASKA BUREAU OF -VITAL STATISTICS
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<br />William Henry Kell
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<br />Decorha, Iowa
<br />31..NAL/E AND ADDRESS OF MR IP "SICAK CORONER'S PHYSICAN OR COUNTY ATTORNEY) (TYDF O' Pr-V
<br />86
<br />124. DATE D BY REOIETRAR IIIb., oar- riJ .
<br />32& REGISTRAR
<br />. QCT 5 1992 -
<br />Q--f-ember IS. 1906
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<br />Grand Island, NE. Yes Hall - - --
<br />SL - STATE E4 COUNTY
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<br />,Nebraska Hall
<br />Grand Island 1310 W. Division Yes
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<br />IS; FATHER .NAME FIRST MIDDLE
<br />LAST
<br />ST MOTt jR • MAgE14�IAAIE WT
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<br />Charles- -
<br />Kell 1
<br />- -Mar or Moore
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<br />t► WAS DECEASED EYEII !N U.S ARMED FORCEBT
<br />_�GTA��TFI�
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<br />Ethel Marie Kell 1��310 W. Division -Grand island,
<br />No
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<br />- 20C. CEMETERY OR CREMATORY - NAME 200. L T m - CRY OR TOWN STAT[
<br />OOAMgn ,
<br />Cremation -Oct: - -1; 1992
<br />Central,Nebraska Cremation Gibbon, NE.
<br />21. ELIBALmM : SIOMATURE E UCENSE NO ,; .. , . ..
<br />22 FUNERAL HOME - NAME AND ADDRESS ISTIIFT OR RF.D. Np, CRY OR TOWN. STALE. 21P1
<br />'Not Embalmed'-- -
<br />A fel= Butler -G,edd -' 1..
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<br />31..NAL/E AND ADDRESS OF MR IP "SICAK CORONER'S PHYSICAN OR COUNTY ATTORNEY) (TYDF O' Pr-V
<br />- Anne Mor M.D. 29 Custer; Grand Island, "Nebraska
<br />124. DATE D BY REOIETRAR IIIb., oar- riJ .
<br />32& REGISTRAR
<br />. QCT 5 1992 -
<br />LEGAL: Lot 8, Block 1, Elm Place Addition to the city of
<br />Grand Island, Hall County, Nebraska
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