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<br />WHEN THIS Copy CARDS TIE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN
<br />SYSTEM, R CERTF ES THE BELOW TO BE A TRUE COPY OF THE ORMWAL RECMQ -ON
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STATW.
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. _TA
<br />DATE OF ISSUANCE
<br />AUG 1 9 2003
<br />LINCOLN, NEBRASKA
<br />HiCH IS _
<br />200311411 AqAkEya R'
<br />AftS SfA "&1STRAfr
<br />HEALTH MAIAAATAN SERVICES'SVSTE`M
<br />STATE OF NEORASU- OVARTIMIT OF
<br />9UKW OF WTAL STATISTICS - -
<br />CERTIFICATE Of DEATH , ; - , 86".'081 7I
<br />0
<br />a
<br />DICIDEW-MAW
<br />r.)
<br />Orville William Levander
<br />Male
<br />July 22, 1986
<br />- lo•R•, M•«irm
<br />6dI«l. J S J
<br />'
<br />NT O.9., Nelia•l Mwice•,
<br />O•r•lol, Nt.) ( NFI Mo
<br />�an
<br />E -wo EMA/•T
<br />NDER I
<br />DATE OF SMITH (M L, Ooy, Tr.)
<br />MOS. . DAYS
<br />., Wgf�e
<br />Amer OV
<br />73
<br />;
<br />Feb. 26, 1913
<br />STATE CM AND IRTH ( 11•f Ill U.S.A., C WNA C
<br />�Sut on, Nebraska 19. U.S.A.
<br />aDrr �( 'J
<br />Helen Spielman
<br />„.
<br />SOCIAL U NWMSER
<br />U OCCUPATION (Gies N•d e/work e«l. dwirp «w► KIND
<br />OF WSINESS OR INDUSTRY
<br />C
<br />506 -20 -9187
<br />'t'
<br />3_�
<br />Laundromat
<br />Hall
<br />12.
<br />, b.
<br />, .
<br />Cifr. TOWN OR LOCATION OF DEATH
<br />INSIDE CITT UMITS
<br />HOSMTAL OR OTHER MISTITUTION -Hw (N.N i• •ilAdr. K
<br />NOM. OR NNT. ldigl• DOA.
<br />Grand Island
<br />y ea N•'
<br />OWF•M•
<br />Memorial Hasp.
<br />Ra., vr•M••l(S,wij)
<br />Inpatient
<br />,b
<br />,.1ran°"9"iftand
<br />RESIDENCE-STATE
<br />COUNTY Cm, TOWN OR LOCATION
<br />STREW AND HUNKER
<br />INSIDE CITT UNITS
<br />tuNebraska
<br />Tab. Hall Isc. Grand Island
<br />Ise. 1609 W. Stolle Park
<br />( YwMN•J
<br />, es
<br />William - -- Levander
<br />HAM rim LAST
<br />Ada - -- Johnson.
<br />WAS RIVER IN U.S. ARMED FORCES?
<br />INFORMANT- NAME - RELATIONSHIP- MAILING ADDRESS (PIEFF OR LCD. NO.. DIT OR IOwN STATE. n"
<br />nw. w. « ••Ul (M ,w. 9i.• wr •d a•r. M rnk•)
<br />it No
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<br />T$elen Levander -Wife -1609 W. Stolle Park -Grand slammd
<br />ERR. c ••ldi••, %am"
<br />CEMETERY OR CREMATORY -NAME
<br />LOCATION CITY OR TOWN STATE
<br />IMb.
<br />July 26, 1986
<br />1wd:'
<br />a,. Burial
<br />zk. Sutton Cemetery
<br />Sutton Nebraska
<br />- i UCENGE NO.JZ p P�y
<br />FUNERAL HOME - NAME AND ADDRESS (STSEET OR LF.D. No.. My OR TOwN. STATE, =O)
<br />2A fel- Butler - Geddes 1123 W. 2nd -Grand Island NE. 68801
<br />DATE OF DEA , Dq, Yr.)
<br />r.) . HOUR
<br />UP MATH
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<br />22a. Jul 22 1 86
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<br />ADDRESS of c ( E IAN OR C ATT (Tpp• w Prim)
<br />David R. Colan M.D. 729 N. Custer Grand Island, NE. 68801
<br />r- REGUIVAR
<br />OATS r (M•., Dap, 14.1 —�
<br />JUL 2 8 1986
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