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<br />Arthur Fra3* Sohwioger Made
<br />1, Mar 229 1977
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<br />TN Westlawn Memorial Park
<br />n1 Grand Island Neb.
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<br />EMSAIMIR- SIGNA REGISTRAR- SMA/ MI .
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<br />1820 156. x n n �
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<br />'_.- _,•WHEN ;:THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA
<br />STATE ),EPARTMENT OF HEAL'T'H, IT CERTIFIES THE ABOVE TO BE
<br />A TRViV,.}OPY OF AN ORIGINAL RECORD ON FILE WITH THE STATE
<br />DEPAR NT OF HEALTH, BUREAU OF VITAL STATISTICS, WHICH
<br />1.S -TH1 LEGAL DEPOSITO�RY� ,F/OR� VITAAL RECORDS. Hof :�q
<br />LINCOLN, NEBRASKA
<br />Issued June 1, 1977
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