|
WNIEN MS COPYCARRES THE RAISED SEAL OF THE NEBRASKA STATE DEPARTMENT OFHEAL TH.
<br />TT CERTFIES THE BELOW TO BEA TRUE COPY OF AN ORIGINAL RECORDNONME WIM THE STATE
<br />DEPARTMENT OF HEALTH, BUREAU OF WAL STATISTICS, WHICH IS THE" "-LEGAL O&VWDRY FOR
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE 200315358 Y PER
<br />JUL 12 1995 ASSISTANT STATEREGISTRAR
<br />LINCOLN, NEBRASKA NEBRASKA DEPARTMENT OF HEALTH
<br />STATE Of NEBRASKA - DEPARTMENT OF BEALTH _-
<br />BUREAU OF VITAL STATISTICS -- -__
<br />CERTIFICATE OF DEATM- —
<br />DECEDENT NAME Ei4F, MIDDLE III
<br />-6EF -
<br />).W,¢OE DEwlx .uvu.^pv vw.
<br />Carl Arthur Martin Hoffer
<br />Male
<br />June 29, 1995
<br />c�L.xD,r,rE DE TSm,x .IM.D,. ame wl.,x,.
<br />- ALTS:, ne.
<br />3wt's
<br />AIEDF eIPTx u„M D,-.�„S_'
<br />6DMarch
<br />D.
<br />xHwMS
<br />- . -_-
<br />Reliance, South Dakota
<br />AF 78
<br />20, 1917
<br />SOECAL)ECUFnr xuMTSEP - -__..
<br />e, 1LA,Y - DEA,H —._
<br />506 -12 -7770
<br />_. _ ❑ IM— _-. ❑ .,.e�.I;N —F
<br />® E GAMS— ❑ MNa.I...
<br />F-ILiT.. Name io l.x.,,,NI N7. Pve IFAU AM N.n,eRi
<br />Mary Lanning Memorial Hospital
<br />❑ FDA ❑ CH-SAL,
<br />CITY Tw+N ON LOCU,ox OF F�TH M IN
<br />SK- M11
<br />..OUxT.orcw.m
<br />Hastings
<br />Adams
<br />A NIIIOF-F 9n,e
<br />","T, 1, 1111 TOWN�LOLOx
<br />INEIRTANONUUeEe a m rtv END
<br />I Nebraska
<br />Grand Island
<br />228 N. Ruby, 68803 1. k] AN L]
<br />o eam w OLEIC Fix. ax.rIL ,^
<br />sx. xP IML„ AK. "IT GMMO xa
<br />TS ®M.NwON ❑ w wE
<br />I -i NAME MF EFFUSE .... „.,..,„,..."„„
<br />eln xI'White
<br />A�`'hi
<br />IE American
<br />NEvEP P
<br />Pauline P. Reimers
<br />uswLaccuPAriox a dro�mTe aTAn^w xwDW DU9NLdINUUS,Nr DUCATON ERNS n+NIal.nv "N. R,q — -
<br />Ne ...w .N -
<br />- v KAAATIio,a Ce.w.:I.,,. a..
<br />`
<br />Owner /Operator Car et Service
<br />FnTNEP. nnME ;WS; _ 1I1 us ,• MOnILI -"'IT _. -- MIDSA MAIDEN SIMMER
<br />I,A
<br />Jacob Hoffer Eva Schaffer
<br />,E A, DECE<ssc WO, x UE AMULD FENCES =��/ /
<br />12 1942
<br />IPA wFFNMAN, -ACME - _ -._.....
<br />„ ^,
<br />Yes World War I 11 1 1 94
<br />Pauline Hoffer
<br />W EFDIN.MAI NIFUNC ADDxE.S ,I'l lOPFF D NO QNSORNFWN STATE ZER
<br />228 N. Ruby Ave. Grand Island, Nebraska 68803
<br />zoo wTF
<br />A' MUR
<br />`194nrooaaOVTO
<br />All
<br />qy,�� /:,,ytj X❑auNM ❑P.N.N.� 07/03/1995 Grand Island Citv Cemetery
<br />nN
<br />zI' F N ME ML gMR.xAMR CEMETExv TI I:HEMaINTEL «aICAL CITY OR TOWN STFTE-
<br />nn
<br />""'"' ❑Pnu° IF
<br />A fe1- Butler- Geddes Funeral Ho e�'cI _Island,
<br />TINEFAL HOME ADDPEES ISTPEE, OP PF D NO ELI OF VSKY ETRE iiP1.. - _Nebraska _
<br />1123 West Second Grand Island Nebraska 68801 -5899
<br />DA,ISP FEN ENEFOM A1m1All EAU Mw.m ueNaeNmaN e.e yam
<br />11, _ - ECU��F
<br />'��SF:NF
<br />-- - --
<br />,O OP AS ACOxsEWENCE DF -1—. —1
<br />INS
<br />cDFw oNUacoxseouExw or M�sraW „I,NUraN,
<br />- --
<br />AFF. F MUH wAST RAE ..
<br />MECE11
<br />.s EF Dm MEu uL
<br />A.P,GINLNSiMNo-uPOICNDT's
<br />FNEF
<br />i
<br />x vw THE FAST MTw xs^
<br />FN . I.Aw
<br />u
<br />ARE Al
<br />.m Nn-Lx
<br />YEA L1 WW�
<br />Fm
<br />a�DATE OnxIUPV iro. O,.. vy
<br />NE, LOTS OE UUUMr
<br />zm. DeseaeE HOT' lx.ue. DCCOPMRO .. __. -_ --
<br />❑ A Nttm ❑ u mm:
<br />M
<br />E e ❑ A
<br />y IN,MPVA,W
<br />ems= F. Ia.m,I,
<br />a NFN „ML N, X NO ax,FwN
<br />❑ H K .,,
<br />Noo
<br />_❑
<br />� 01: ,
<br />NA FATE:TNED - ,.
<br />DFDEATH
<br />I June 29, 1995
<br />_.
<br />c
<br />g
<br />d1
<br />APONOONCEDOEAO 11 OR, v,. . FNCNOONCEDJFID WA,
<br />'n
<br />>
<br />~aTF Ep )R TWF OF OFArn
<br />xF➢ IM Oav m
<br />M
<br />i
<br />aim
<br />M
<br />a-
<br />,Qy�
<br />+w m� ^np OQ
<br />SE
<br />arnm neain eeew.a
<br />M9
<br />ww>Iwwnl,
<br />$I`-
<br />EN WAAa'e I'M,a"Wel,ubN
<br />5 auuA amL
<br />MI.NaIe
<br />Ive E1 THIN
<br />W qo TOTSACCOUSE COx1N&ITEL MCA T.a
<br />HASCPoMOP,ISEOE COIUivw DEFx HE 11 3A
<br />wA)COx)Em Gw.mm+
<br />yTH+
<br />❑ IFS ❑ W ONFNOWN
<br />vF5 ❑
<br />�II���y
<br />-- - ❑ vL5 &NC,
<br />31 NAME AND ADONESS OF CERTIFIER I vxvSCUx. COOLANT' S 1x LAN IN UUUN I v A I I wN[c even rvw
<br />Dr. John A. Beek, M.D. 715 N. St. Joseph
<br />Hastings, Nebraska 68901
<br />J�e w +EFILEDDJULA101995
<br />
|