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<br />
<br />88- 100234
<br />
<br />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'OF'HEALTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPQS ITQRiYPOR , '
<br />- ,,[ .
<br />VITAL RECORDS.
<br />
<br />DATE OF ISSUANCE
<br />1981
<br />
<br />~-':;:.-::J'~.;.~-<~j'~." :.""
<br />... ~~. , .~-
<br />. ..,.. ri" :" -'-'. ..
<br />. -j ~. . . '
<br />STANLEY S.; 'C-O-QP:ER~~..~bI.RECTOR
<br />,.' {' .' \
<br />BUREAU OF VITAL StATISTICS
<br />
<br />DEe 8
<br />
<br />LINCOLN, NEBRASKA
<br />
<br />I DfCfDfNT HAMf
<br />
<br />STAn OF NEIUSKA-DEPARTMENT OF HEALTH
<br />BUREAU OF VITAL STATISTICS
<br />CERTIFICATE OF DEATH h - L~'"
<br />MIDDlE L\S SEX DATE Of DEATH (Mo.. 00,. Yd
<br />
<br />fllST
<br />
<br />
<br />Wilma
<br />
<br />Br
<br />
<br />1987
<br />
<br />1.
<br />lACE (e.g._ Whit., .toe.. A..rico.. <>>IGIN/OIESCENT (e.g_, Itolion, Me.icon.
<br />'"dig". .k.J {S.lH}fyJ
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<br />Cln AND STATE Of I'ITH tllltO' ;11 U.S.A..
<br />na.... r.Oy"tr,J
<br />I Butler County,
<br />SOCI"l SECUIITY NU"IU
<br />
<br />506-20-3660
<br />
<br />lib Grand Island
<br />IESIDENCE - ST..n COUNTY
<br />
<br />150 Nebraska 15b
<br />'ATHER NAME .1
<br />
<br />Hall
<br />"'DDlE
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<br />John
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<br />16.
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<br />BURIAL. CreMotion. hmovol DAT
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<br />1987 10. Westlawn Memorial
<br />fUNU"l HOME NAME AND ADDUSS
<br />2]VY1,
<br />11
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<br />68801
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<br />Grand Island
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<br />NE
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<br />68802
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<br />OAn IlCIIVID IY ItGISt... (Mo_. Do,. y,.,
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<br />IUb DEe 7 1987
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<br />260. IS;"...,,,,.,.
<br />27. I_EDI..n C"USE
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