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<br />(lj\/~EN THIS COPY CARRIES/THE RAISED SEAL OF THE NEBRASKA l)TATE
<br />, DEPARTMENT OF HEALTH. IT CERTIFIES THE BELOW TO BE A ;'.fRl!'~: COPY
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPAB.TmT. 'pFHE,ALTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITOR~,\;FOIV
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<br />VITAL RECORDS. J.k.~j~'~~_J::r~~~~~~l ,
<br />
<br />DATE OF ISSUANCE kf1~ ...... ."1'rI!:f'f: ,
<br />JUl 2 8 913 STANLEY~~:~,Q~~/D~'CTOR
<br />BUREAU OFVli~t l)TATISTICS
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<br />LINCOLN, NEBRASKA
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<br />STAff. Of NEIlIASIlA-OEPAJmIENT Of HEALTlI
<br />aU.EAU OF VITAL STATISTICS
<br />CERTIFICATE OF DEATH :
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<br />Nebraska
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<br />Inpatient
<br />INSlDt: cln LIMITS
<br />Division ~~:~i~~B"H.J
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<br />Daniel Joseph
<br />WAS DlCIAIID IVII IN u.s. AWID JOIeIS?
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<br />C. Nissen
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<br />lIT1l1!l 011' g NO. em 01 'C'ff188DI11PJ
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<br />I~della Hegarty(Wife) 404 E. Division, Grand Island, Ne.
<br />C!MEIEIY 01 CII!MAlOIT NAME Loc...ltON CITY 01 TOWN 5lATI!
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<br />.1- . Gordon
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<br />11, 1988 2...Westlawn Memorial Park 2001. Grand Island, Nebraska
<br />:::J3 y Y 'UNItAL HOMf NAME AND A.ODlESS 1:1'''11 01 U,D_ NO.. (In CM tOWN. ST.n. 'In 68801
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<br />2~ivingston-Sondermann 505 West Koenig, Grand Island, Ne.
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<br />PIONOUNCI!D DEAD (Hour)
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<br />Grand Island, NE 68802
<br />DATE IICEIVED IT IEGIST..I (M... Do,. Y,.)
<br />15S88
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