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87.,t,,. 105704 <br />WHEN THIS COPY CARRIES THE RAISED ML OF THE NKBRA59A STATE <br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO 54'A TA"', CQ'?y <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPAjtTMv0r`OF KEALpj <br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL Dc"" <br />VITAL RECORDS. fog, <br />DATE OF ISSUANCE A. <br />SEP 4W . �w ; <br />STANIIEY <br />LINCOLN, NED BUREAU OF VITA.1,11STAMPTICS <br />1417 EA� <br />Mae <br />oil <br />STATt Of NESSASKA- WARTWIT 4W MMTM <br />rJaw W VITAL STAUSTI" <br />CERTIF-ICATE OF DEATH <br />A <br />1 t987 <br />B Garn A I g u s:tA <br />Mo OAY <br />its <br />American a��93 <br />�Rffl .4 Mbruar� 7, 1894 <br />--ewww WIWI- <br />the -ft�fj <br />"Dowip, MO <br />--,JMrr <br />�errck Count y, Kebrask,!� U. S. A to Widow Charles NMN Garn <br />4 11 <br />Seamstress - Self -Em p!d jjpt hin Hamilton <br />r <br />ON OTHER 1"S"TuTto" - M.— (ff.., <br />RCN 04 tocina" 00 MLAIM <br />I p—ff— 1W <br />Aurora. Nebraska 110--neTpriAl Hoqpital �pp <br />CITY, TOWN 01 10C.Af <br />11161011KII - SIATI :GUMM TV j�;__Term. <br />u Nebraska Hall 1 W. 5th----- es <br />o,�-w I - ILI <br />5, Grand Isl <br />Mobbir Lis] <br />Herman NMN Daberkow <br />NMN Jaenicke <br />W^6 954iii <br />OT4111 01111 0 MO. CRT of TOWN. <br />NO ------ 18th, Grand Island Ne. 68.801 <br />507 E. <br />----------- <br />ou c' w;7 1 ce"Iffly Of cle�loa NAME T i4 CITY 001TOWN $TAT# <br />Sur=ia r.Au 2 1 , <br />_12.87 Island City Cemeteryl2od Grand <br />26 hli,�ej WAi6*j --eiii-ai-TOWN. . <br />FUNIIIAL W)AA1 <br />68801 <br />-Sondermann 505 <br />72Livingston West Koenig, Grand <br />Island, Ne. <br />s. <br />r <br />2" <br />Vn <br />-10 2", (4--.0 F...' low <br />oil <br />J416AA& <br />-MKfM OKY-CRI ICAV f t 6-'W'W- iiij-- AUG 2 6 IM <br />b- <br />1W <br />1:1 <br />i = fs".* <br />..- W. —.-I <br />L <br />L. <br />0106po N. <br />. "W <br />M <br />M <br />