Laserfiche WebLink
<br />88-106818 <br /> <br />WIlEN THIS, COPY CARRIES THE RAISED SEAL OF TilE NE~.Ilki~J\/IjTATE <br />DIlI:'ARTHENT OF HEALTlI. IT CERTIFIES TIlE J1ELOW;,T'o'ilJ!;A.,TlI.tJ~~OPY <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATll'DEP~"oi,llEALTH <br />BUREAU OF VITAL STATISTICS. WIIICH IS TIlE );F.Gi\1iDim,lTqll~ ~.9\l <br />VITAl. RECORDS. " ': ,';" ;1;: : ~, ' <br />A""L",l"'~~:o;.,: <br />. ".. . <br />. ..,' ~ <br />, , 7. ~ 'n'\1_ ,,",' <br />STANLEY S; 16ooha,"DIRECTOR <br />BUREAU OF VITAL STATISTICS <br /> <br />DATE OF ISSUANCE <br />JUN 7 198& <br />LINCOLN. NEBRASKA <br /> <br />STAn Of HEIUSU-DEPA.ITIUNT OF HU1TH Lot 5~ B~Clf. ~. Parkhill <br />IURUU OF VITal STAnSTlCS eeon 5 c1i v:j.sion f an Addi- <br />CERTIFICATE OF DEATH i~~lin ~ ail ce5fu,~y. G~~~aska <br /> <br /> <br />;- DECEDENT NAMI <br /> <br />.ID' <br /> <br />Adilee <br />-J.- <br /> <br />MlPOlE <br /> <br />Kl uck <br />tslU!l 01 ., '0 NO. ON Dt fOWN. SUll. ZIP) <br /> <br />",Leon H. Horn 2221 W. Phoenix Av. Grand Island He. 68801 <br />CVtmn DI C.f;MA'OI1'-N...,." lOCAJlON cmoatOWN STAn <br /> <br />:l1k.Central Ne.. Cremation Serv.2Od. Gibbon Nebraska <br />'UNflAl. HOME_HAME AND ADDIfSS 1 r2'f~~"'2;.od C'St~ fOWM.l1Atl. ll~ <br /> <br />nA fel-Butler-Geddes 1 <br />.:~i OA SIGN '....00,. "..1 rlOUIOI' DUTH <br /> <br /> <br />ji5.. ~:-HOUNaoDt!AD ~:'NOUNCI!DDlADtH_J <br />r;~i (M...D.,.'fr.I <br />'" ~~z 2ok. ~L.- M <br />!~Ie ~::.~.._.~.t.:-..".::!='::':::""'''''''.---- <br /> <br />u' 2"'S.,_~""'1'" <br />01 COUNTY ATTO,NET) ,Tn>> Dr "ri"', <br /> <br />A.E. VanWie H.D. <br />UGl5TlA1 <br /> <br />908 N. <br /> <br />Ne. 68801 <br />DAn IlCEJVI!D .,. Il!GIU..... (Ma~ Dor. ".J <br />JUH 2 1988 <br /> <br />2...U..__I"- <br />2 . IMMlDIA I tAU I UHfl. ONlT ONE AUSE Pl. UNf .01 {a/. rbI, AND fell <br />':': c."",c...< f.,J ~ I-t....- 1- F",' I.. r_ <br />DUe TO. 01 AS"'1t. CONIIQUeNCI Of. <br /> <br />, I--'__.....~. <br /> <br />I <br />,..._l~_."""''' <br /> <br />,.. <br />tlUI fO, 01 ~ .. CCNIIQUINCI Of, <br /> <br />: "'_l~_."""" <br /> <br />'" <br />p-:r ~ <br /> <br />ACCUItMT. UICUII. MDIIICIOl. UMDIf. DAT! QllJolJ"- ,Moo.. 0.,. '"j <br />01 ~ MftInGaTlOM f~""1 <br />..., <br />""un.'~ <br />r~ifrT_""" <br /> <br /> <br />[ <br /> <br />- <br />