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<br />STATE OF NEBRASKA _ ._. __ .
<br />WHEN THIS COpy CARRIES THE RAISED SEAL OF THE NEBRASKA HEALTH AND HUMAN SERVICES
<br />SYSTEM, IT CERTIFIES THE BELOW TO BE A TRUE COpy OF THE ORIGINAL RECOBD ON FILE WITH
<br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL STAT/SII/iS'SEC;~WHICH IS
<br />THE LEGAL DEPOSITORY FOR VITAL RECORDS. ~.. --.-=:~-'-'-""~';l-~1,.;2-"'-
<br />
<br />DATE OF ISSUANCE _ ..~-:~ ,. .. ... iff ~:tt
<br />MAY 0 1 2007 tc CO i _J~~L#"'=$. i'..ii!>~R
<br />20 0 7 0 3 615 ASS#STAi!tg.flfJ?~GI$""R~R
<br />H~f.o,"TJt._AN,! HUMAN'~~'Y~~S
<br />
<br />\h
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<br />
<br />LINCOLN, NEBRASKA
<br />
<br />-
<br />
<br />-.-
<br />
<br />. .- -- ~-1l
<br />
<br />STAT! OF _au -IJIIIIAII1'MINT OF HEALTH
<br />....... OF VITAL ITA11ITICS
<br />CERTIFICATE OF DEATH
<br />
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<br />: --=' .:~-~'~~.~~ =:.=~:- -_::'.~'~-'
<br />
<br />---96....02136
<br />
<br />... lIOS
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<br />
<br />a.lMlEOFBIlTI4 -DIy. ~Nt/
<br />February 15, 1917
<br />
<br />Russell
<br />
<br />llIlIIlLf
<br />William
<br />
<br />lAST
<br />O'Neill
<br />
<br />2 SEll
<br />Male
<br />
<br />3 OATEOFDEATH _ 0.,. YoWl
<br />February 13, 1996
<br />
<br />I. OlCEllfNT..
<br />
<br />
<br />. ClTy_srA OF.,TH 1It...;.USA-__
<br />Grand Island, Nebraska
<br />1 SOCIIlI. SIQ.IRTlY
<br />
<br />IIa IIl)E - ..... ......,
<br />fYo51 78
<br />
<br />DAYS
<br />
<br />508-10-2316
<br />
<br />.. PLACEOf'IIEA'"
<br />~~g-
<br />DEROOlIpOMOI
<br />DIlOA
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<br />()lHEA 0--
<br />D-
<br />O (lho/~'
<br />
<br />,ACIUtY._ /11___---
<br />St. Prancis Medical Center
<br />
<br />
<br />.. Y fOlllNOIILOCATIDtIOFOPf"
<br />Grand Island
<br />
<br />.. COUNtY OF DEATH
<br />
<br />Nebraska
<br />
<br />
<br />... 5f11Uf.ua..- --.z.Ca*/
<br />68803
<br />
<br />.. INSIOE CITY \.MfS
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<br />III-&~;enter 'S'-" House Bldg./Moving
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<br />~".401~.,
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<br />Jeuole
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<br />Knight
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<br />Central HE Cremation Serviee
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<br />t'U"':JI4t~
<br />
<br />1'.11
<br />
<br />Gibbon, Nebraska
<br />
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<br />
<br />Granel lslanel, .ebraslea 68801
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<br />Lot Two Hundred Seventy (270), in West Lawn, an Addition to the City of Grand Island, Hall
<br />County, Nebraska
<br />
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