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<br />He: Lot Twenty (20), Block One (1), Knickrehm Fourth Addition to the City <br />of Grand Island, Hall County, Nebraska <br /> <br />88- 104578 <br /> <br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE <br />DEPARTMENT OF HEALTH. IT CERTIFIES THE BELOW TO~.' IllfOPY <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE D '~.: . )JJ!ALTH <br />BUREAU OF VITAL STATISTICS. WHICH IS THE LEGA~. iP~~fJi.!, <br />VITAL RECORDS. ... r" ,..' ' <br /> <br />A14~ <br /> <br />STANLEY"a.,'. ~OQP.ER; DIRECTOR <br />BUREAU Ol>~~* ~~#ICS <br />:'~r.., <br /> <br />DATE OF ISSUANCE <br /> <br />AUG <br /> <br />41988 <br /> <br />LINCOLN. NEBRASKA <br /> <br />STATlOF NEUASICA-DE'ARTIIEIIT Df HEALTH <br />IUREAU Of VITal STATllnes <br />CERTifiCATE Of DEATH <br /> <br /> <br />DIN _HAM <br /> <br />LA <br /> <br />A'.... 0.,. Tr' <br /> <br />1 <br />.... -1.-... W .... <br /> <br />Nebraska <br /> <br />- <br /> <br />" <br /> <br />pfcl-Butler-Gcddes 1123 W. 2nd, Grand Island, NE. 6BBOI <br /> <br />flSi ,: ..., " J <br />I~ HOHOUN(IDDtAD .--. <br />t f ,... 0., .. J <br />JI~ ....0-..____.:;.:___..: <br />: yl :.-:-...-:::-:.:;.......-- <br />'., ,......,.,.., <br /> <br />AM <br /> <br />r( <br /> <br />,.. <br />HOMOUNCID DIAD'.....' <br /> <br />..,.. <br />~ <br /> <br /> <br />I <br />, .......----_....~ <br /> <br />: ....... ---- ........ ... <br /> <br />........ <br /> <br />.- <br />r.......'......' <br /> <br />"... <br /> <br />...... <br /> <br />L <br /> <br />.-J <br />