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<br />I <br /> <br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE <br />DEPARTJ.fENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A TRUE COpy' <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTJ.fENT OF HEALT>> <br />BUREAU OF VITAL STATISTICS, wllICH IS THE LEGAL DEPOSITORY Foi( ,;' I <br />VITAL RECORDS. /' .,' ".- <br /> <br />DATE OF ISSUANCE <br />JAN 7 1986 <br /> <br />j.IA.~J.~..J: A~j~".'\ ',,~~-, ': <br />/J1~..: .~~rr;::'I.:(=~' <br />STANLEY S. 'CO..o?~R~ DI~~CT~P.< <br />, ' . ~~ I __ .-~ <br />BUREAU OF VI~4~!~~;~tTi~~~ <br /> <br />" '-"'''' -..."'-,.... -...~. ~., <br /> <br />LINCO~ NEBRAS~ p(1!~ ~ <br />~UE~""'''\~ ~ ~~""-~ 1i. . <br />.. f .;/1: (~ /1 ? ~ J- { $ <br />, es. ee <br />STAn OF NEIRASKA-DEPARTMEWT OF HEALTH <br />BUREAU OF VITAL STATISTICS <br />CERTIFICATE OF DEATH 1-<,-; oD <br /> <br />aa~.6591 <br /> <br /> <br />OECfDEH ........f <br /> <br />F1UT <br /> <br />Ml DU <br /> <br />LAT <br /> <br />I. Anna Loui:3e <br />lACE -(e-9.. Whit.; 1100:11. .....ricoft OIIGIN/OESCfNT (..~_. tMlion. M..icon. <br />'"dio,,_ .fir.' (SpKily) 0..''''01'1, .tc.) (SpMi/.,J /0 <br />. whi te 5. <br />CIN AND STAn Of IIITH IH _, i. U.S.1I.. <br />no..... cow""'r} <br />I. Grand Is land <br />SOCIAl SECUlllY "UMIU <br /> <br />I.b. Grand I s land <br />I IESIDENCE - STUE COUHlY <br /> <br />~ 150. Nebraska J"b. <br />'ATHU N......E fll , <br />I <br /> <br />Hall <br />MIDDlE <br /> <br />Brabander <br /> <br />16 Edward H. <br />WAS DfCEASED EVUIN U.S. A....ED fOICES? <br />ll.,. no. 00' ""II., (If ,.... ,i... _0' o..d dOl.. 0' ,,""'c.) <br />18 no <br />8URIAl. Cremotion, rtemc>>'Ol At <br /> <br />IsrlUl 01 ... 0 NO. 0" O_lOWN. $JATf. lIP) <br /> <br />STATE <br /> <br />200. Burial lOb Jan 4 1986 ~O;: Westlawn 20.1 Grand Island Nebraska <br />EMIAIJo\U SIG.....TURE,& IICf..SE..O, .;l.) IS fUNUAl HOMf -NAMf AND ADDRfSS ,""UI 01 "' D 1+0. (IN 01 10_. SIAl(, ,". <br /> <br />21 ~.1M~1 C- C{f~ 22 Apfel Funeral Home. Wood River. Nebraska 68883 <br />Tf Ol' DfATH IMo.. Do" y,. DA E IGN 1M.. Do" y,.J HOUIOf DEATH <br />~ 230. JANUARY 1 ~ 98 Hb. M <br />.~ DATE SIGNED (Mo.. Oar. Yr.) HOUI 0' DEATH ,IOHOUNCED OFA~ (Hrur! <br /> <br />!~ 23<. 1: 26am <br />Ji M <br />~! <br /> <br /> <br />DUANE DAKER <br /> <br />Grand Island Memorial Hospital <br /> <br />Grand Island.Ne <br /> <br />68803 <br /> <br /> <br />DAn RECflVfD IY IEGISVIlAI 1M... Do,. y,.J <br />JAN 3 1986 <br /> <br />260.IS.iI_tv'.,.... <br />27. IMMfOlAU CAUSE <br />'~IJ "r- / _. _. <br />I (____~~'-...-<.~< ~\_Jt~, <br />I' <br />DU" TO. 01 AS A CONSEQUENCE Of, <br /> <br />261>. <br /> <br />1...._1 I:t..--- -",.. 01"1' d_rh <br /> <br />Sudden <br /> <br />..........1 I:t--.- eft'" GAd dCtGtt. <br /> <br />t"Z$ <br /> <br />One Hour <br /> <br />.M ::c- <br /> <br />~f ........._ _Mf .IId d_* <br /> <br />Id <br />'AIT <br />II <br /> <br />CIrD <br /> <br />Two Years <br /> <br /> <br />Kit StGKt.t(ANT CONOfTlOHS C...d__ c_tribwttag "* d_tll b... II.' '''0-.4 <br /> <br />WA.$ CASI II.fflIO 'f0 M.CHCAl <br />fVoMlNI. 01 COlON" <br />IpN'" Y., 0' No' <br />29. <br /> <br />DATI ()IlH'UIY'...... Do,. Y,-, <br /> <br />300. <br />fHJUI' "T WOlttl <br />IS"....I, Y.. ... PH, <br /> <br />JOd. <br /> <br />CII'Y 0It TOWN "." <br /> <br />STII" 01 I' D He <br /> <br />JOe. <br /> <br />L <br /> <br />I <br /> <br />~ <br /> <br />~ <br />-1) <br />