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r N � @ r crT @ �■ N 07 //.0 WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORMONFILE WITH THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISMS WpTigW,4 iICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS. -_ _ -- DATE OF ISSUANCE �} ANLEY S. 6066 ER AUG 1 7 2005 200508263 A0ISTAI'- TSTAr9a Gi-STRAR LINCOLN, NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM VrrALXrA7S= - CERTHqCATE 0011RATH 9.9 . NaME __ a ov1 M n n March 1, 1999 • AND X nef it usZ OWW O010"I SL m f • , ;;N we I Cairo, Nebraska '" "40 * '�.' :� U) C'7) U) XDSrrr ❑ 0~ NIrrA, X.M 506 01 3654 ❑ ER O ON" ❑ 1MIAIrIee c n= MA ❑ a"AMMOA ft CITY TOIM ON IOCA OF DEATH EM. M. OOUWv OF 007k ° T« :E] N. ❑ Hall ft RESIDE7ICH -STATE ft ft WrITUMORLOCATim 0"N"F m- M Nebraska ry =n© 2104 S Adass VOL] +r❑ t0 It, ANCeXW In. N WL ftem Mp' a MAW= MOW Ej t9 . - - - OWN *To&" M CD M Barbara Nsiefskl- fttArs 149 101A 000UPAT@N /t* WffM *dU'Md0r)fAMI/f�"� 1Ak.0MOFEUEwEe{INDurm Ak: / eJ n. "7 P/yP�ANp PTPn ectrician m i_ G� ` (dec.) Maxie Andersen Ch EVER .1 U B. AFOAD FOFCM I ,9L . %AM Yesmw' ZIf7I0"- 4fM -18 -46 I Barbara Rasmussen M *9%"1AART MAMMADDqM ISTREET OR RF.D. .."Y Tom STATE ICI 210 5 dams Grand Island, Nebraska 68801 0 r, Cam R DAT( trc mfmwoftv&�u an t *�t/Z ®eIP -I ❑ R March 4 1999 acv In. G�� �s Fdm al. Hwe ❑ "t0A ❑ '° Grand Island Nebraska KUN6UU. HOME ADDRESS i8'fREET 011 N.F.D. NO.. CrtT OR . STA Lp Second Avenue Grand Islzsnd IENTERO&YowCAUBf mM�V.Iftmeso state cancer with Bone metastasis. ; 4 fears n A COMMUENCE OF nutrition ACAIA9EOUENCA;OF I .IM,YMA„IIOIr.�IA„A1� 1 I IC! � PART OTHER CONpTIOGrr - C04%Ww ',N{MFr1a lo M $tP OO M OMW PAIR • IF . "S TXISAE A M. AUVOFSY $. wABCME PREOIµ Iev IN THE PAST ] MORTHIr ExMAW®RN lIgRp011OPMW N Advance Dementia IAun,o-" V« f7l N. .: rn M. see DATE Os P4VM' Ar. An wJ 7Cc u0IA1 OF rrANrY $a DESCRICE HOPI NAA ►OCCURRED ❑ AccOwM ❑ IYmwm" rn ' I-- "a C-0 $. P4rURr AT ur01M 9M P '! OF MAC • Al IsR. t4rw� EMI. N.Nry 2% ux--d1 STIrtET OR 74i b. MP. p*V O11TOrMt /TwTaE % W"Mowoh Y" � No ❑ •MM Co Ua iV March 1, 1999 1w[ PIrONO►, W DEAD AY AW W 1 i PrAP OUNCID OB1D rbw DATE $*WD Alb. A yr yr i pTe T11M OF DEATH arch 3 1944 5:0 aIP r cri 00 Cn co 2 L 0 YES 11 ND RflA1iNCMI1/ I ❑ WS F] No ❑ va 13 NO j 3t NAME AND AODI49$ OF CTATIFR EPl1�. S ftM5 " ATTO W*v' 'Twff P1rr/, llAyodele Abel A edun MD VA Greater Neb Health Care S stem Grand Island NE 68W3 3sa WkSTRAR DATE my vL"W W Ow. AV w! MR R MR cn p //.0 WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL RECORMONFILE WITH THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATISMS WpTigW,4 iICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS. -_ _ -- DATE OF ISSUANCE �} ANLEY S. 6066 ER AUG 1 7 2005 200508263 A0ISTAI'- TSTAr9a Gi-STRAR LINCOLN, NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM VrrALXrA7S= - CERTHqCATE 0011RATH 9.9 . NaME __ a ov1 al�rin Miwi Arnold Hans Rasmussen Male March 1, 1999 • AND X nef it usZ OWW O010"I SL 1 f • , ;;N we I Cairo, Nebraska '" "40 * January 3, 1909 XDSrrr ❑ 0~ NIrrA, X.M 506 01 3654 ❑ ER O ON" ❑ 1MIAIrIee • F • Nrr /r •+MIAyR PM waa�yMrbA7 VA Greater Nebras�ra Heath Care System❑ MA ❑ a"AMMOA ft CITY TOIM ON IOCA OF DEATH EM. M. OOUWv OF 007k Grand Island T« :E] N. ❑ Hall ft RESIDE7ICH -STATE ft ft WrITUMORLOCATim 0"N"F m- M Nebraska Hall Grand Island 2104 S Adass VOL] +r❑ t0 It, ANCeXW In. N WL ftem Mp' a MAW= MOW Ej t9 . - - - OWN *To&" •"A"W White Danish O' NOW aMa�cro Barbara Nsiefskl- fttArs 149 101A 000UPAT@N /t* WffM *dU'Md0r)fAMI/f�"� 1Ak.0MOFEUEwEe{INDurm Ak: / eJ n. "7 P/yP�ANp PTPn ectrician Power Company 'o-tw °i''m " {''" St FATHER -NMI- RM UVOM LAST IT (dec.) Charlie Rasmussen (dec.) Maxie Andersen M WAS DECEASED EVER .1 U B. AFOAD FOFCM I ,9L . %AM Yesmw' ZIf7I0"- 4fM -18 -46 I Barbara Rasmussen M *9%"1AART MAMMADDqM ISTREET OR RF.D. .."Y Tom STATE ICI 210 5 dams Grand Island, Nebraska 68801 sa 27M R DAT( trc mfmwoftv&�u an t *�t/Z ®eIP -I ❑ R March 4 1999 acv In. G�� �s Fdm al. Hwe ❑ "t0A ❑ '° Grand Island Nebraska KUN6UU. HOME ADDRESS i8'fREET 011 N.F.D. NO.. CrtT OR . STA Lp Second Avenue Grand Islzsnd IENTERO&YowCAUBf mM�V.Iftmeso state cancer with Bone metastasis. ; 4 fears n A COMMUENCE OF nutrition ACAIA9EOUENCA;OF I .IM,YMA„IIOIr.�IA„A1� 1 I IC! � PART OTHER CONpTIOGrr - C04%Ww ',N{MFr1a lo M $tP OO M OMW PAIR • IF . "S TXISAE A M. AUVOFSY $. wABCME PREOIµ Iev IN THE PAST ] MORTHIr ExMAW®RN lIgRp011OPMW N Advance Dementia IAun,o-" V« f7l N. Ter NP Ttit N. M. see DATE Os P4VM' Ar. An wJ 7Cc u0IA1 OF rrANrY $a DESCRICE HOPI NAA ►OCCURRED ❑ AccOwM ❑ IYmwm" ❑ POO I Y $. P4rURr AT ur01M 9M P '! OF MAC • Al IsR. t4rw� EMI. N.Nry 2% ux--d1 STIrtET OR 74i b. MP. p*V O11TOrMt /TwTaE % W"Mowoh Y" � No ❑ •MM . DATE OF D-ATX Ab DW n) 00 DATE "M M. V* "I an TIME OF Ora" March 1, 1999 1w[ PIrONO►, W DEAD AY AW W 1 i PrAP OUNCID OB1D rbw DATE $*WD Alb. A yr yr i pTe T11M OF DEATH arch 3 1944 5:0 aIP r Z t —" MO UK ^, 3W WUT@ TO . -HE DEATH? � �..e HAS Oft" OR "O K O& A"M SEEN L 0 YES 11 ND RflA1iNCMI1/ I ❑ WS F] No ❑ va 13 NO j 3t NAME AND AODI49$ OF CTATIFR EPl1�. S ftM5 " ATTO W*v' 'Twff P1rr/, llAyodele Abel A edun MD VA Greater Neb Health Care S stem Grand Island NE 68W3 3sa WkSTRAR DATE my vL"W W Ow. AV w! MR R MR