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87-- 106828 <br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE <br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A TRUE COPY <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMENT OF HEALTH <br />r BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITORY FOR <br />I VITAL RECORDS. <br />DATE OF ISSUANCE <br />AUG 13 07 STANLEY S. COOPER, DIRECTOR <br />LINCOLN, NEBRASKA BUREAU OF VITAL STATISTICS <br />STATE OF NEBRASKA - DEPARTMENT OF HEALTH <br />BUREAU OF VITAL STATISTICS <br />CERTIFICATE OF DEATH <br />IDICIDINT-NAME Its All LA K A A H (Me., DP,, r /.) <br />ROY LEON OLESON male Av st 3, 1987 <br />RAC c-(t.ITq., YrbiN, tleel, Awerien O"GIN /DESCENT(.. q., Inl;ew,/M.iean, A E -Iw t 111 UK— TEAL UNDER 1 DAT DA OE tIRTN( <br />/eIM7Ili�C p«ih/ G.r.w.e, ef.ERp.3ary (T..) <br />Mos.. owns Nouts. MINs. <br />1 A ATE OF tIRTH(d MI iw U.S.A., CITI EN Of WHA COUNTRYMAINE ,NEVER MARRIED, NAME OF SPOUSE (N.;h. q;6 <br />WIDOWED. DIVORCED(Sp.3;fT) <br />Paul Nebraska #UI.S.A. 1o.Married nDovie P e'o <br />SOCIAL SECUUiT HUNTER USUAL OCCUPAnON (Gir. Liwde /.e.L den. dr.;nq ron KINDOIIUSINESS OR INDUSTRY COUNTTOF FAIN <br />a <br />1250,-01-9889 u. Cl enter ub.Lumber Yard <br />-Nt .. II M <br />INST CITY, TOWN O N INSIDE CITY LIMITS HOSPITAL DR OTHER INSTITUTION w,b. Hall I.du.m OOA. <br />Grand Island (Sp..i/,/ele,Ne) q;.. m.lewdw ,V 0.ye...111 Aw. 1.P.Nw.l3, «Arl <br />mb. Ia,. es Idd. VA Medical Center ,d.. in atient <br />RESIDENCE-STATE COUNTY CITY, TOWN OR LOCATION STRIPY AND NVMIER INSIDE CITI LIMITS <br />Nel t rS...i/.r....N.l <br />w _NAM M, - <br />--- " .x. o1J a l.lausen Ave I ISe. e$ <br />U NER -MAT NNAM! IR µl Iw <br />SURIAL Geese I-. Md. I A G <br />GEMETERT OR CREMATORr -NAME <br />N CITY W TOWN STATE <br />m.. Burial 2Din 2 <br />20.. Paul Nebraska <br />AIM R- SIGNATURLS IKtNSE NO. I <br />IUNERAI NOME -NAME AND AODI SS IfiMET OR fJ. D. NO_ Clry OE,O.M. STATE. DN LCO/yA <br />M(11' \ <br />2:. Jaoobmen Faaaral. H=o 411 Now Strart St. Pahl. V <br />DEATH (Me., De,, rr.) A <br />A N (Me. et, Y..) N UR DEATH' <br />ust 3 1987 ! <br />!gi 24e. 2 <br />LN"ITIFICIR M <br />24b. M <br />R OF DEATH ►RONOVNCED DtAD <br />� f110NOUNCED D[AD(Ne..) <br />g. 6, 1987 . <br />.2 £Cz[ .. e <br />eF «, L.wN. « <br />«..N iNl.l 2 <br />MY N . r. <br />2A. ISiq..l....N rid.). R <br />,.DMVOar d i al infarct <br />R AA CONSEOUINCE Of <br />Agee <br />.wk.s w <br />.N d..M <br />1� <br />r- <br />1 <br />h, <br />I__ ". <br />