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<br />104726 <br /> <br />WIlEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE <br />DEPARTMENT OF HEALTH. IT CERT U'IES THE BELOW '1'0' BE' A TRUE COPY <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE' DEPARTMENT OF HEALTH <br />BUREAU OF VITAL STATISTICS. WHICH IS THE. LEGAL DEPOSITORY FOR <br />VITAL RECORDS. <br /> <br />88- <br /> <br />MAR 3 0 1988 <br />LINCOLN. NEBRASKA <br /> <br />Jif.,J....j ,A',;Mi,if" <br />/./TMMMY"., !~'fr-' <br />STANLEY'S. COOP,ER. DlRECTOR <br />BUREAU ,OF VLT'l\!" 'STATISTICS <br /> <br />DATE OF ISSUANCE <br /> <br />.... OICIDfN' - HAM' <br /> <br /> <br />STaTE Of NtlUSIlA-DlPAIITIIEIlT Of HULTH <br />IURUU Df VITaL STaTlsncs <br />CERTIFICATE OF DEATH <br /> <br />".n <br /> <br />MIOOl.( <br /> <br />0"'" IMtl. 1kI,. Y, I <br /> <br />19, ]988 <br /> <br />IlllotNCI - StAn <br />IS. Nebraska <br />. <br /> <br />Lou i Be <br /> <br />N. <br /> <br />Felps <br /> <br />,IN'()&IlI.ANI _ HAM' IUIItI 01 I' 0 NO. CIll' ~ lOW.... "All. Jl'. <br />:" Loui.se Pearson-Mo ther-She 1 ton, NE ~ 68876 <br />ca.u..,o.CUM,AIOtT-N......1 LOCATION CI'NOI'TOWH stAn <br /> <br />xw Shelton. Nebraska <br />1""1f 01 . I 0 NO. c,n 011 TOWN. '''',11. 1''1 <br /> <br />Bill Shreffler H <br />1101' <br /> <br />... ;~.,~-;;~ CAUK <br />,... <br />:~~~D~:.~l:C~~~,ie,s from bein <br /> <br />struck and run over b <br />two automobiles <br /> <br />o e <br />, ........"--........ <br /> <br />... <br />WI ro. 01 AI A tOMHQUIHCI 01, <br /> <br />: ..........--.-1..... <br /> <br /> <br />.. <br />p...,. unwliIQ.-cMII...-._-c..-.---........ - --- <br />. <br /> <br />r..... '.-"" <br />no <br /> <br />[ <br />