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<br />87 105417
<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO HE A TRUE COPY
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMENT OF HEALTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL, DEPOSITORY FOR
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE 4U*41
<br />AUG Z 4 W STANLEY S. COOPER, DIRECTOR
<br />LINCOLN, NEBRASKA BUREAU OF VITAL STATISTICS
<br />STAIR OF M3NA5KA- D6FAWr=" OF HEALTH
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