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<br />88-107025
<br />
<br />WIlEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA ST~TE ..
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A T1iQ!!:P9PJi,'!:; I
<br />OF AN ORIr.INAL I'.ECORD (IN FILE WITH THE s'rATE DEPART~T:':Ot. :Hl\AI.:TH,": .
<br />BUREAU OF ".l~_I. STATISTICS, WIIICH IS THE LEGAL DEPO~.~~.ORKF.OR":. .~ ,
<br />
<br />VITAL RECOE'.,. j.ll""'LJ"'~~~"')":~'~
<br />
<br />DATE OF ISSUANCE $MJUIf" .~"(-..,) .: :1/:,
<br />
<br />STANLEY s. cOOPER:,l)lREC:TOii.-', ..
<br />"f,'_ . 'J" # ~ ,
<br />BUREAU OF VITAL :st~Trs-r:td'..-
<br />&~t!/- f' IJ4 ///e4" 's,,?aI'/
<br />
<br />DEe 2 3 1988
<br />LINCOLN. NEBRASKA
<br />t." -I .:2
<br />
<br />STAn IIf NEIU$IlA-DlPAIITIIEIIT OF HUlTll
<br />IUIEAlI Of VITAL STAnsnC$
<br />CERTIFICATE OF DEATH p. ' ~D
<br />N -H A H ,__.. bar. 1',.J
<br />
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<br />ii
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<br />
<br />
<br />I~Gerald Allen, Husband,
<br />C!MIlIO 01 ell!lMlon -NAME
<br />
<br />Julia Samea
<br />IStllln (II: ..f D. NO~ on ~'ft'lJbYATl, lip)
<br />1109 W 8th Grand Island Nebr
<br />LOCATION cm 01 TOWN ST.rl!
<br />
<br />"
<br />
<br />"J.lestlawn Memorial Park .....Grand Island, Nebraska
<br />'UN!1Al ttOMl!-HAJAf AND ADtMrfSS (".n01 U,D, NO.. CIf'1'0I1O\'tfII. SlA'l.lm 68801
<br />".Apfel-Butler-Geddes, 1123 W 2nd St., Grand Island, HE
<br />. DA N ,.. ,. r, HaUl DlA'"
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<br />AN I" 'HY 'AN 01 COUNTY AnOINl!ll1 ".e ... 'ri""
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<br />PRONOUNClD DfAD CH.u,)
<br />
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<br />
<br />Dr. B. D. Urbauer,
<br />
<br />Grand Island, Nebraska 68803
<br />DAn! II!CI!IVID I' IIGI 'Ut (Me., Oar. Y,.J
<br />DEe 22 1888
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