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<br />, <br /> <br />I <br /> <br />IIIIEN THIS COPY CARRIES THE RAISED SEAL ~~~E\Pn2.~& 7TATE <br />. -01!:PARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO 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 />DATE OF ISSUANCE <br />SEP 2 1988 <br />LINCOLN, NEBRASKA <br /> <br />~j. <br />STANLEY S. COOPER, DIRECTOR <br />BUREAU OF VITAL STATISTICS <br /> <br />IOCIAL .!ifCUtfTY HU"III <br /> <br /> <br />sun Of NEBRASKA-DEPARTMENT DF HEALTH <br />BUREAU DF VITAL STAnsncs <br />CERTIFICATE OF DEATH <br /> <br />88 06066 <br /> <br />t'fC!DlHl_HAM.l <br /> <br />Thomas <br /> <br />Ra on <br /> <br />1920 <br /> <br />1S. Nebraska <br />A H -"'IoN. <br /> <br />Grover Cleveland <br />WAS DfCrA!fD rvu IN U S AIMlD fOltCfS' <br />~; y;;ut;;wi r-2-=i7':i.i/9='i'1-45 <br />t OAI <br /> <br />lIMN Macklin <br /> <br />(S,.... 0.., 0 NO~ Cln Of row.... ""'". ZIP) <br /> <br /> <br />"Doris Brown(Wife) 548 Johnson Dr. Grand Island, Ne.68803 <br />tlM.tllT 01 (.,.......Ion NA.W1 lOCATION CtnOllOWN SIAn <br /> <br />:r6erl,._.,,'~ <br />~p IMMfDtATI CAU:Iof . trHI" ONt <br />-:: Se~s.'s.. <br />OUI 10. 01 .u.. co )lOUlNet 01. <br /> <br />12. 1988 20. Rosehill Cemeter 20d Emerson Nebraska <br />.-4S?c2 'UHUA\ ""o...l_H.u.Af """" ADOIUS IlT..n 011'0 NO. C'" 0II1t1wN. IUt,11, 1111 68801 <br /> <br />:n Livin ston-Sondermann 505 West Koen! , Grand Island, Ne. <br />Ii. 0" I H (Mta De,. '(..J HCUIOI' aLUM <br /> <br />i~i 2" '4lb <br />t;~f :::~:'~;'~JDD''''D rlONO:JhC[DDt~!I'f_1 <br />v~r, . a <br />JAB 0.......... .__._ .004,.. _--'._. I. -r or-- ...,.. ......... OIl <br />J: J ______ ~8v ~h_..........~r..,._......~....-w_ <br />.~ va tq.,so._........r....... ~ <br />II' 'H' rclAN 01 COUN" AnOINEl) fJ,,.. at ,,..,,, I: <br />Lv....-bl..... 9C'6 D. 4o=:.r - G.-~..! ~!>t,,-~. JJ<.. b&'ir;s <br />DATI IICII'Il'!D " ..GIU....1 {Iq_. ,. "., <br />,... MAY 2 3 19118 <br /> <br />'0> <br />DUt TO. 01 AS.. COHUQUINCI 0'1 <br /> <br />.~~-.......... <br /> <br />! ~-'~~~~. <br /> <br />i "'_1,"- _.004 ..-.. <br /> <br /> <br />.".uCAIIII'fI~OD""DlUol <br />11A.MIJoj(IQlC I <br />~r.._",-, 0 <br /> <br />"'" <br />""'WT"1~ <br />rs_"'....... <br /> <br />em 01 JOWH n.... <br />