Laserfiche WebLink
<br />J, ~fJj <br />)\..tMll eu, <br /> <br />~ { 6t')JI (.-J.J;pvJ\f.kr- ~j <br />)( ,~"",j -'..- <br />~ ~.td MTATE OF NEBRASKA-DEPARTMENT OF HEALTH <br />/ Baft.. "r VII.I 51.11.,1e. I <br />CERTIFICATE OF DEATH' <br /> <br />I 't-V~7 <br />/ <br /> <br />-I.u-V) :h. ()-~..J' ~.,;." <br /> <br />ASIO HAMf <br /> <br />'1111 <br /> <br />. ,'~" -"'. , <br /> <br />B8~ 1 O~,~ ~9,.~ <br />. " ~ '. i. <br />"A1I till ...... . <br />DATE or DlAlIt I MDN'". ,aT. "1.11 <br />I Jul7 20. 1"'1 <br /> <br />.. .~:' <br /> <br />J ,." <br /> <br />'e. o. '11"" IN <br />'.MIl"", .... <br />r '111'H NO tl' <br /> <br /> <br />l' <br /> <br />HAM tiP MOl IN 1""", UIVI 11." II'" HUMI" J <br /> <br />I \U.l\ atlielNCI <br />Mr. OKIAIID <br />'lID. If OfAfH <br />:CU.D.... <br />'&flfUhOH, om <br />$IOlMCI N'O. <br />'MiIlION. <br />~ <br /> <br />~ 0nDd h18ll4 ,. N 404 ElI-' Dl.,i.ioft StzHt <br />SlATE Of ,11TH lIP Nor IN V,I..... ......t anlEN or WHAT COUN'TIY MAltM!D. tllfYEl MAllfED. SlMYlY1NG 5POUS! (I' w'''. 0"'1 _el" NMIII <br />t. ab Ita '0"''''''. Ual ,~;wao ,""'.., ,,;ldel1. I. (1lboJ:t) 1Ioftl..., <br />SOCIAl SlCURlTY NUMBEI USUAl OCCUPATION ,01"" a....a 0' -oe. I;0oI. DUll NO MOllO' KfHO Of 1U51Nf55 OIl INDUSllY <br />.a.,HO "",;/" l~,a I COMtl'UGUOD <br /> <br /> <br />,.. <br />MOTHE! MAIDEN NAME <br /> <br /> <br />, D1\'1.1oa St, <br /> <br />" <br /> <br />" <br /> <br />V.l'II1l1. <br /> <br />ru4 <br /> <br />'10. <br />...., I <br />;r-'. <br /> <br />"",,",INO AOCRf55 'SRlIt o. I,',D. NO, em 01 .ow.... n.", ,... <br />II. 4U4 EM' D1'f111ioD St., Grand lel8D4 .e 68801 <br /> <br />__.__.~~~!..f~~l"..~"!t (~~_"'~~ fal. rbl. "NO ((ll I'~". oNllf'" .... <br /> <br />(OJ <br /> <br />teriosclerotic Heart Disease sudden <br /> <br />COM.III0M'. " .......1 <br />*MICM 0"'''' 11'1 10 lb) <br />~~:11:~"':::~'~~:~~ ou. 10. eM AI III CO..UOU'"CI O' <br />LYING C"UlI l"" <br /> <br />1'1 <br /> <br />,t.CC1Dt:NT. SUICIOI. HOMlClDI. <br />01 UN~!D ',,",CI"I <br />... <br />INMY ~, WOIIl <br />"""" n. CM HOJ <br /> <br /> <br />....oo.r". C/oOl'."'.11 HO <br /> <br /> <br />If fe' Will ....".0. C" <br />.......0 1M DI'...."'I.O CAUII <br />Of DI""" <br />"0. <br /> <br />PMI'll. 01"11 SIGNifiCANT CONDlTtONl CONDtTIOHI Co.>ot'IIIU'IMG 10 DIA'" IU' NO' "LAIIO "If Ul I' 'IMAlL W&I '"81 It. <br />10 CAUSI GIVeN 1M .AIT Ie_) I'UGMANC'r IN T"' '&IT :I MONtHS! <br />YUl.J NOD <br /> <br />.~ " <br /> <br />111___ "" *___"__ <br />lOCAnON '''"'' Ot I' O. NO.. ('fT 01 10W.. l1&n 1 <br /> <br /> <br /> <br />lit <br /> <br />.... <br />CHt1ACA11ON- ,.... <br />'"fS~I::WHD'D THI 6' TO 7 20 <br />fl. Mc.....O..O' B 53 11. <br />CfITIftCATtQN-MlOICAL EJNMlIfI 01 COlONEl OM ,Nt .....'1 ()lI' ,.. <br />1......nGM Of fill IOD'I .MO/o. nil '"","110011110101. 'M MT CW"'ION. <br />DI.'" OCC'*"D QfoI ... DAn ....D Dut '0 hi' CAU""" ''''riD <br />110 .__ ..____._, _ <br />Cll'lWMI-NAMf In.. 01 .11"" <br /> <br />'71 <br /> <br />no. <br />MAM.1<<1 ~,s en,.... <br />no <br />.UII...... CIlMAT1ON. _MaYAl <br />::c...'k'1a1 <br />:Tt J817 '~. 1m' <br /> <br />fMaAI.MIl - SIGNA rUI' I UCIH5f NO <br />.SIt. /s/ /Jo'ranci" H. lurrlv <br /> <br />.-wes tl.&loIJ1. MeIlOr.l.al...Flglt .. L~~ON . GaDd i;~ <br />fu~.a~~~""."5O;'r~KMfIi' 'O!dIl4 181_ .. <br />n, ....- <br />IfGIITlAI SIGN. TUff <br /> <br />i. <br />68801 <br /> <br />.. IIC IYID " LOCAl leoIIT."'1 <br />