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<br />88- 106196
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA,STAtE"
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE,~A TB.1{f 20~Y,
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPAR'fNl!i','O!_-~TH
<br />BUREAU OF VITAL STATISTICS. WHICH IS THE LEGAL ~,~~I~!>Ry,'FOR",,:~~
<br />VITAl. RECORDS, 1../6 .,:'1 ~ i' '!U,('. - '; ',~:L
<br />
<br />DATE OF ISSUANCE ,.(jf1l"'f,...J~ ) ~~:
<br />NOV 3 1988 STANLEY S.(:cio~Eir.~"DII!'Ile'io&'
<br />LINCOLN. NEBRASKA BUREAU OF Vr:T~:.s;~isTt~'5'
<br />
<br />S,-,-i\L3~ rG~ae..~ /",-"D"6,):~r- ~Uo.rL
<br />!TAlE lFllDUIllA-DlPAIIIWIIr Of 1lUL1M
<br />_ OfVITALITAnmcs
<br />CERTIFICATE OF DEATH
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<br />85 03512
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<br />1985
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<br />Henderso Della
<br />INIlOIMANT-NAlM-IIL4rIONIH"-MM.1NG ADOIfIS ,llIIn DlU,D. NO~ cmOll'OWlit .ltl1hJ~
<br />
<br />,,_R. Gordon Smith 3027 W. Cs itsl A t 032 Gran~etsi~l
<br />CIMlTlft' ~ CltNt'QIf-N..... lOCATION cmOl TOWN srAn
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<br />HL Weatlawn Cemtery
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<br />xw. Grand Island, Nebraska
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<br />.Apfel-Butler-Gsddes 1123 W. 2nd Grand Island, Ne.68801
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