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<br />rm CNE (1), BLOCK 'lHIRIEEN (13), CLAUSSEN CDlNTR'i VIEW ADDITION
<br />TO THE CITY OF GRAND ISLAND, HALL CDUNTY, NEBRASKA. 88
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA ST~ 102252
<br />DEPARTMENT OF HEALTH. IT CERTIFIES THE BELOW TO BE, A TRUE, COpy
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTM~T OF 'HEALTH .
<br />BUREAU OF VITAL STATISTICS I WHICH IS THE LEGAL DEPOSI-TORY':F,OR ,/', :' ' .
<br />VITAL RECORDS.-,,' ". "'>, , "" \
<br />
<br />~'J{~/~".
<br />
<br />STANLEY s ~ d99J?~R'.. U.~l~CTPR'
<br />"., ',' ~ I ~ t. '~'," , ""
<br />BUREAU OF VITALSTATl:$XtpS ':
<br />
<br />DATE OF IS~CE
<br />APR 27'"
<br />
<br />LINCOLN. NEBRASKA
<br />
<br />PHIM.IV.) IlZV l.o 4-57. '
<br />DEPAIITIIDIT 0.. PUBUC HLU.TII,
<br />EDUCATlOIf AND Wa.rAlUl:
<br />
<br />BnmI NO. 12.........
<br />
<br />· t. ftAa... MA1'It
<br />., COVIITY Hall
<br />
<br />to CITY. TOWlit, CllI LOCA'f1Olll
<br />Grand Ialand
<br />~. ..a..c llf' 11/.'. ..,.,.,.....",,., ......
<br />=.,'~: 1004 South Vine St.
<br />,. IS I't.ACCllf' OlAfM tllStCK Ct y u..'n' us 1t0
<br />
<br />STAU OF NEBRASKA
<br />DEPA&TMENTOF BEALTB
<br />...... 01 Vital Stau.ua
<br />CERTIFlCA'I'E OF DEATH
<br />
<br />6'0 11253
<br />
<br />STATE nu NO....,~.....,.".............."....,....................".,
<br />
<br />IS ."6 t
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<br />I. UIIUA&. ........,.-__. It_, .~w-.........)
<br />.0 STATe Nebr. t. COUIlYY Hall
<br />
<br />r. CITY, TOWII,O. LOCATlOIt
<br />Grand Island
<br />... sncn AODlIUS
<br />1004 South Vine St.
<br />
<br />r. Ultl'" 011 STAY III I.
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<br />3, 1M.. ..
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<br />SIX
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<br />MIIIh
<br />K. SCHROEDm
<br />1 "AIIII_D Ii ..WI....1I111100 . DATI 06 .'"'M
<br />A ril 16
<br />
<br />,. IS IIU'DlIICI IIISIIll CITY LlNITS' us
<br />1100
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<br />. DAlI
<br />06
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<br />MINNIE
<br />, CCK.OIl 011 IUlCl
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<br />H. S. AM
<br />'4. IIAN. llf' MUS....O n. W"f
<br />
<br />FeJU.le White
<br />I., USUAL OCCU'aTlOlIl cOW 1111141.,_11...,
<br />....,., ..., ., _11111' hit, __ 1/ ""'"..1
<br />Housewife
<br />.... '.T...ltS U"I
<br />
<br />Dick H, small
<br />15, .,A5 DCCtaSlD IVI. '" U S, a..ID POIlUS'
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<br />No
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<br />
<br />Minnie Gulzow
<br />II toelAL SleUIIIT... NO,
<br />
<br />Schroeder
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<br />Grand Island Nebr.
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<br />_,uR"Ur1a.l~.:''':_ .1Q.-;t9-60 Westlawn Cemet Grand Island, r~ebr.
<br />14 DAn wceD IT W.GIS"'''' lIS. ...~A~S SIGoIIATU . -' ~.. "AliI 0' 1I0.TUAIl' ADOIIn'
<br />OCT 2:) 1~GO _/,~,,4/ ~/-( Livingston-Sondernann lirand Island. Nebr.
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