Laserfiche WebLink
10 <br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE <br />DZPARTKINT OF HEALTH. IT CERTIFIES THE BELOW TO BE A TRUE COPY <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMW,Or ,H TH <br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL D <br />VITAL RECORDS. FOR.. <br />DATE OF ISSUANCE m <br />a <br />OCT 13 STANI. • : r . 4V TOR <br />LINCOLN, NEBRASKA BUREAU'Vfs # WT pgT/q@ <br />S 6 "4'� -i bbli <br />87 -106116 <br />%rrATE (SP NEBRASKA-QEFARTNENT OF HEALTH <br />m,e <br />ftl or Vial .%W1011" <br />CERTIFICATE OF DEATH IIl_: 1.3 73 f158 fl <br />—NAM! rNW r a ax- <br />HENRY IL C S. 1 I male <br />f 5/26/72 <br />MCS tA«N, «Gala. waaKw aNww, <br />AOE —u" <br />vwNa i u <br />I v <br />DACE OF NRO, I Ne«� ",, "', <br />cOUMY 0E MATH _. <br />WiC. 4l1 <br />NWN <br />rR. I�I(Irt® <br />�L <br />fNlgryrlrHCCI <br />7GV <br />TMfl rfI^'Ilil <br />. <br />f <br />/. Hall <br />Cffv. TOWN. 04 WCATKM OF A <br />M/W/ Cm IaNR <br />1nt«r rlf W MO <br />Al oym, —NI pRI IN Iln«1, GM {fH! •rW «wWN 1 <br />Orand Island <br />,,;Yes <br />,. Jt Francis Hospital <br />SUN 0 SM�M . N wor wr u s .., w.0 <br />01 wrMl cWMR1 <br />MARNO. WM MANWO, <br />VNW. POUR'. MNf• 3.1 —W . -W I �^ <br />calNlm, <br />.. :debraaka <br />_ <br />, UJ <br />WIOOW[o. ,MKNrr <br />N mart <br />, Lida nrumlef '.:right <br />waii mumm <br />1/KW OCCUFAT,ON ,om ■wW or w•olA eoM Aw1«o won W <br />KMD OF RUSMRSS 011 INDUS /R1 <br />,f. 542 -18 -1323 <br />�RNIrW INT, Mw N N11f/.1 <br />1,, costodian 1` <br />,,.Grand Island Fublic a^chool 33rstem <br />RlSIDfT,Ct —f ►•R <br />cO1w/11 <br />CITY, IoWN, OR tOCAT10N <br />I«aT1 m. ft <br />SIRM AND " <br />Nebraska <br />Hall <br />Island <br />I WC." IIf m «R I <br />Ma <br />m <br />, «Grand <br />I. Yes <br />11. 523 E 10th <br />FA —NAME rglp w,glr ufl MOTHER— <br />MAIO[N NAME tall rwsNr un <br />N Gilliam ; <br />