|
L
<br />, rZ¢ / ° ! % j „:^}' ?t ,: -A� ,',.a -t'r•' � f” `�` . -i�,. , , 44-- 9 ,j t 0) � 'G'i �'r .1� /'J.
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEB KA $TATS
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE -A TRUE `'COPY
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPAA OF HEALTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEP0tTTOHY FOR
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE ,
<br />STANLF,1l, S., COOPER,. "DIRECTOR
<br />An 3W
<br />LINCOLN, NEBRASKA BUREAU '*,,-v,1TAI ".,STATISTICS
<br />STAn of NEORA W_ 09PARTUM Of TN 87-102195
<br />IUKM Of WAL SMSTICa
<br />CERTIFICATE OF DEATH.--
<br />N (M... D.r. Yr. ) UTI OF
<br />_6k1Nvff__j4W may L"T [So le
<br />Tar,,. MAP Stander I. Fema , March 26, 1987
<br />Wiib LAMNw. a.R.. N.fa.n[p. R«.IW, uNW11I AtI u I OAi
<br />.
<br />.) rsrK+hl o.r.w..ss I(SSNNiTT) rr,..) Aws. DAYS NOUfS • wNS. Se C . 18 -1913
<br />73 P
<br />ite American
<br />A ROM T .M .. U.f A . wNA COUNT IMR110, S[ (If.40. R^• Pa.,"Y,MOwt0.
<br />01vORCED(SyHerbert Stander
<br />IS Nebraska �. U.S.A. ,a Married „
<br />,
<br />INRh NUAu[R YSY _CwAIIOM fG:.. I:N d...s d... I..:q .r./ RINDOTSUSINESS OlINOUSTM COUNTY Oi DEATN
<br />Me ric County
<br />ngl,
<br />d.«R Aa+ Sheman
<br />-14 -4679 a �lerical 4orker ub our ouae ,,.
<br />N OR TocATNIN Oa Ob1TN NUM[ CITY l4MlTS NOSnrµ a OTN[R INSnTUT10N - N.w /NNT1. I.Mw D04
<br />WN^a..
<br />lS..•�h 7n.. N./ R^• +I
<br />fifs Hospital „°.Inpatient
<br />up City ,., ,acreeart
<br />-STAT[ COUNTY CITY, TOWN OR LOCATION SIMIT AND NUrMlR INSME CITY UNITS
<br />es raska i3b. Hall ,:< Grand Island ,sr 425 E. 20th SC. ,s.�
<br />FATIM NAN It MIMI
<br />William --- Lavelle Nellie --- Sherwood
<br />wAf 01K[A3[D EY[R Ni Y.S. ALUM [ORClST IN.ORMANT -NAAH - nswrronsnr►- .IAUiNC ADO11[SS ,seen a ., o No. cm OS 8w }urs. sv,
<br />sand,
<br />Stander- Husband_ -425 E. 20th St. -Grand I
<br />,[Herbert
<br />SURIAL Cr .06 ., br...l ClMETNY M CRlAMTORT -NAM! CITY CN TOWN SATE
<br />=-A
<br />rch 30, 1987
<br />Westlawn Memorial Park nd Island, NE.
<br />Burial T Ta _
<br />R fUNlRµ MOAN -NAME AND 1ODRQ15 (11110111 01 R, 0. NO CITY M TOWN, STATL "T
<br />Q
<br />,,Apfel -Butler - Geddes 1123 W. 2nd, Grand Island, NE. 688(
<br />i$
<br />Yr.) -- -
<br />3_jg- 67
<br />--
<br />rj1�
<br />OATI WHID (AM. ,. Y../
<br />,,. _
<br />I.
<br />7.b M
<br />(M... �'
<br />}LEE
<br />C
<br />.RONOUNCEDMAD
<br />IM.. 0.,. Y')
<br />►WNOUMCEO D[AO fNe.•!
<br />S 3J' j tt.. M
<br />i
<br />SNb.
<br />�M., M..I..aw A�.a• M M... M ..i rl.....1 M w W
<br />O. h b.r. M ...r.r ...M ..+.W+• " •, .N.+.• M.M «.....I w
<br />Ne,
<br />i
<br />V. Aaantachai M.D. 130 N. 6th,, Loup City, NE. 68853
<br />Y pw.. o.T. TO
<br />VIA ., ......,► � APR 3 tEBT
<br />77. UNIIIIIIIIA" CAUSE
<br />( [ ON[ lfN[ !tH fa , f !, AND (41 �'1•^•I ��""'" °A"' "� �"'�
<br />Par �uSkN
<br />� urp i[lAArbC aTN/itR.a•lrsAl --
<br />A CON t -- a.....1 ►.e.... r.« .M 4.M
<br />&&yM tat ccc,A0 >fc HIS bA> T'tth -t6 ccrc2tc fit•
<br />W[ 10. Of AS A CONS[OUENC! Of:
<br />a
<br />E.
<br />it
<br />0
<br />_1
<br />
|