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$TAT[ OF WN "M- Of►AIlTIIMNT 0 NMTN <br />fiNlf" (w Yim STATISTlef 87--105416 <br />ClUfFICATE OF DEATH <br />Am :411014b' Dicim rsoll t'4410 J04lua lU 1900 <br />_ <br />�-t, -W. ihN1.ANSn [►i�jl+ip M.i+a(. VW l YID!_ ._ - .T tSi'Atllll lrAN.lIaY."1�i:i.'T <br />aaei€p., wT ttrn+0n.0N 11� tr! r9nd S PAYS N S <br />rli t� ♦iLkU(i«ati <br />0 _ J14 ( a,t392 <br />l - Hw n off"t <br />�ala�lt 1dTZbr€r.ul.r� U13.► lai�(�4tir�ttl r�r�Nur1 <br />�a s `+R _wAw losTfir t"" <br />.r *..Area �. � a �.«►1 <br />0 /ate Int. 1Ga:rVouir�r wal <br />sww ucN09Nttta iTITUT1 -rtw ra Ml,. n <br />(ig,N(p Y,n a. IJA) ytr, n. n.n+b.rl Oe(renaN� 9in.ie9wIM /N «tr! <br />.. Gr€irx3 To?.eel Yct� i4((nnt•ia1 iFen-nitn 'Ti o•t^irand: <br />-S14 t C1lUN99�"- '� CIM,Tt�IWm oatocAllcm � - - 61041 tANO INIMr/� IM Cifl'1WICf <br />T 4*bruslca ,Tw. Hull IS..Gr,ald Inland 1St 1()11 U. 11tH _. <br />gym` F '' &"T ice ! " iiEt <br />_ I dviard Dlakersou �ls unk <br />WAS fT4fC1A 9YTt9 qt U.S. AW90 /09CSSY T 11N109MAN(- -NAAIi - t•EIAtIQN§gM - MAgN/6 AfJANS'{ WOW 04. f 0 NQ, CITY M TOWN. &TAT /, OW <br />w! <br />.l� laQ �T9 '13 y!I11(]T1, J1Ct G "AQTI --lioa ,, 1(1. IlS k_1�., <br />lUbA4, Cr.eenr+ne, lob A <br />CUMAT®RY- NME IOM �m IOCAT CITY CM TOWN STATI <br />izuza�� 1/1.'.� E.iO _ NYae. <br />- T 11 No lu20 rU <br />(.1141 ai r T 0 "0. cm o. To", *TAT#, tnt 6auu1 <br />r <br />122 Iii .atali aortas. J• u1T�.t.a._:L�).1...��._��+rM.. .�a'- a��.ar.,l <br />{r..dAn <br />41 «- «i w a M. y 9 O. sa ►r. d .n.aw «df« M+Mi.«r.n. + ns .vk(.e MNI. «sw.N « <br />N enw oe«..N A.. a w .s.«M •«r.� <br />NOVI CHF MA NCn 6dTF Ni61`w3a- F. r. <br />1.,.-�' <br />_ll.l_ -M _ p �46 . <br />E Sh►Tf 01 iM (ATO., ,Yr.j " S � nT(aNauriteOT�Ag '-' � IRANOUNCED GE�ptaaur/ <br />S <br />In <br />T(;A t��ir trFGi�luSi�fi /re; gar, rr1 <br />>w..e ►`�l�p- i•c. <' !rflJ. -(.r <br />-F_° f <br />(#Nyii `r Cn+ C tuft ►er eiNf toli r . fsi. ANQ r ii T +T («n a.«..».«.�..+w«► <br />mm To. CA As A cow <br />9a Gtst �lcat.t� <br />a AS A COi+Sl�ii Yt . E l- mL�- .�--- ---- °--- ---- - -' - -- <br />to _ <br />►�' - - ..tvx.«.«ea..ne., «a..n t <br />... :.e.rs"i ae M ft kc r` rritw Al, N i dP rsa«a, r « «.al i. ArnaAa OWN" <br />all <br />O <br />I.M.-�Mit OT�Ml31Ir (W.. ®nr T. 1 _ IYKVn O! eVNA -rIGMI Ml)M NIOW'/ OCCU.�9 ��- <br />M 19«04.0 G«'fSSWAY4..:3awArr !!I 1+ <br />i <br />t <br />Cm 00 To <br />j ►nut w t a. t" ° _° w+ an_ <br />PHd,r«« w c d1M. ►e.Ep�,w ffwurvl E! <br />WHEN THIS ,COPY CARRIES THE RAISED SEAL OF THE NEBRASKA <br />STATE DEPARTMENT OF HEALTH, IT CERTIFIES THE ABOVE TO BE <br />A TRUE COPY`OF AN ORIGINAL RECORD ON FILE WITH THE STATE <br />D- EPARTNENT.OF'HEALTH, BUREAU OF VITAL STATISTICS, WHICH <br />IS THE LEGAL DEPOSITORY FOR VITAL RECORDS. <br />/RAJ _Ji _ it <br />fTATISTICS,_AND_ASSISTANT STATE REGISTRAR <br />LINCOL14 NOMMMA Issued January 22, 1980 <br />ME <br />6 <br />m <br />