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<br />87 -- 104809
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A TRUE COPY
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMENT -00 ltBALTn,
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITORY FOR
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE
<br />MM 19 I% STANLEY S. CO0FEI(;" DIRECTOR
<br />LINCOLN, NEBRASKA BUREAU OF VITAL kiiISTIC$
<br />sun OF NtMAW_ NMAwfum OF "My"
<br />SUK" OF WFAl STATWU
<br />COn KATE OF OUT WA i.- U 1
<br />910111MINT -UAW "my 011001
<br />DATI Of WIN jo... 6.7� 1,j
<br />Robert Guiou McElroy
<br />ba-we-vPWI..
<br />Male
<br />March 5, 1987
<br />MUCINIfe .m .w.. I A01
<br />e«...ErM rI.N.')79
<br />- W."ad"
<br />go" t t r uAttOr�tfltrw..o.r.r..t —
<br />,Nov. 16, 1907
<br />7A1111111
<br />7
<br />Pam N N- 010
<br />Gr nd Island Ne. S.A.
<br />,�rO1ied�eO`'�� Helen Blackburn
<br />3mi" MEW" [riDOF eUeMNfsMilroMSf"T
<br />COUNTr OF D[ATN
<br />,r.«S M,, aw. I N rNl i
<br />It 506 -09 -5979 , er Partner 11 g.' *tCan
<br />, .Buffalo
<br />CITY. TOWN Oe tOCAWWOr 04TH
<br />ndmcnvuwfs
<br />Ho""Ak Oe OTm "USeT,TUTIOH- m- 10.0- ,irMr, rNDSI.
<br />Oe MH,. r.N.w SoA
<br />Kearns Nebraska
<br />fSt.,nlp r ««w1
<br />,,..Yes
<br />pw Aw,s,•1
<br />I ,iao2rSamaritan Hospital ,,,.
<br />a.•N�•••••rf,Nh,
<br />Inpatient
<br />tt se"Ke -STA1e COINSfr
<br />CITY TOWNOe LOCATION
<br />SM9T AND NUMM
<br />,NS,NCtfl/lras
<br />tl° Nebraaka ,M, all
<br />,�. Grand Island
<br />,x2712 W. Koenig St.
<br />��"'C8k"'N"
<br />low Room L"T Charles T. lkElro
<br />Bertha -- Guiou
<br />WAS efC47t0 em of 414 AMTM eOKM:
<br />DIIOeNAw NATAL- etutroNwa- MAILING ASMSS O+tr1 ON 2.0 a ND.. cT ON 10wN. STAN. un
<br />1-ft - -"I" — *_ — w1 r .- —s
<br />It No
<br />,. Helen McElroy Wife 2712 W. Koenig Grand Island, ite.681
<br />tuaIALCl l"
<br />March 7, 1987
<br />0601" oNce"hA -NA" LOCATION C"vONtow" STAN
<br />>,. Duria JV
<br />SM
<br />»,. Grand Island Citv Ctemetar wd. Grand Island, Nebraska
<br />JUW"A NOW -NAM AM &II8011US (SHUT OR U.a NO.. cm as 1owK sum b•,
<br />1.
<br />' fel- Butler - Geddes 1123 W. 2nd Grand Island, Ne.68801
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<br />3/5/87
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<br />MAMA �«M wawM M
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<br />William M. Vosik,M.D. 1I1LA V Y MWCAL"M I. T. Box 550 Kearney, HE 68847
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<br />- Ca-r-diogenlc shock 8 hra.
<br />ION M ON AS A IOWUQUWJ COL. •� rwTy w...• «r w �«a
<br />s, ASHD with myocardial infarction 48 hours
<br />. a At A C ,Ate d: - F 1.% 0 b-- ~ w Aw,►
<br />N,
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<br />tl uH W,YN ro weKAx
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<br />° ?rior myocardial infarction r., a w 0 r YES
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<br />1D''c'•'°NO
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