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WHEN THIS COPY CARRIES THE RAISED SFAL 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 />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITORY FOR <br />rVITAL RECORDS. <br />DATE OF ISSUANCE <br />FEB 2 C STANLEY S. COOPER, DIRECTOR <br />LINCOLN, NEBRASKA BUREAU OF VITAL STATISTICS <br />a6-- 101860 _ <br />STATE OF uUMSRA -WARTM 11T OF MIXTM <br />/DREAM OF VITAL STATISTICS <br />CERTIFICATE OF DEATH -I w 3 <br />! A N (Ai W. ,., <br />Erna Olga Schultz Female February 4, 1986 <br />E.cE _M �„ t.t ,., ....�.. xeNT N R �•+ ••. w. «....ci- ,...«»+.. uNOeR I .w uNee 1 a. <br />Iw�i.•, .4JIfP..A/'1 A«..., a. 1 fSN.ar/ rynp AIDS. DAYS I NOun AYNf <br />White America ^. ( 70 .► 1.. .""arch 151 1906 <br />• n OE ENIN ( wW .. u S.A., CMZEN OF WHAT COUI — ASARIIID. NEY[t MAMItO. NAM! Or SPOUSE for <br />s'...'.'Nw <br />+M ..rwrr WIDOW M [SMOKED (Sp w�Erl <br />it on Co t Nebra a U.S.A. ID. Married In Hilton Schultz <br />wCSAL uCUw" ISIS, YwAI OCCY ►ATION tC:...»r •f ..rl N'. �w +wE w..r RIND p W $"SS OR INDUSTRY Cou"IT OF DEATN <br />_ -4 13. s wife nr Domestic IA. Hall <br />C,A05NORIOCAflO/1p DlAITS INSMCITY&MUTS NOfnTALOROTNIRINSTItUtION -N.r (N w•1:w «rA.r. rrgM pR MIST w +•.•ooA <br />lfP..:yr « «N.1 I.wMr.M.wfw•w.Y..r O.1•wu.M4r. lw.i..•w...fl•r.,r <br />14b Grand Islan I..- Yes IA/ Wed ewood Nursin2 Home IA. In atient <br />CITY. TOWN W LOCATION STREET ANO NUWER 1NS10E CITT IMNii <br />RESIOIT.C! -fTAtE COUNTT ffp...y Y.r «IWl <br />G d Island IS♦. 2410 W. Anna IS. Yes <br />If. Nebraska w. Ha <br />ATM - <br />Ix ran <br />4 <br />N[l- MAIDIN <br />� iI <br />William Juer en <br />Rath e <br />, Marie <br />Louise Raabe <br />�,.I <br />W-AS DECtASED [v[t IN U.S. AWtD FOlCIS? <br />IN /OWANT -NAME - RE/AUONSNIi - MAfliNG ADM$$ <br />ISrMH ON a 10 ND. Cm W My— vR. IMI <br />� <br />Irw. .•. «.NI�IM M N.•.+r W Y1,.N r.. +.l <br />,PMilton Schultz- llusband -241 W. <br />Anna -G and M9921 NE. <br />to No <br />C[MEfEIY OI CIEMAIOIt-- NAM[ <br />LOCATION CITTORYOWN STATE <br />RURUII. C...r.r:.w.l <br />l <br />Feb. 7, 1986 <br />]o► <br />]0, Grand Cemetery <br />m. <br />Grand Island NE, <br />w.. Bur <br />W At <br />INS[ NO. • >Q� <br />?r <br />_Island <br />SUN[ /.N NOM[ -NAM[ AND ADDRESS (SSNII Ot t 10 <br />w0. Cln 01 IOV+•l StAlt. tIN <br />zA fel- Butler- GeddeDs 1123DrW.D2nd Grand/la s1a„d, NE. 68801 <br />iiaZ <br />DIW.. D.r. T•.1 NOUI f]I <br />D[ATM -2. <br />rRONOUNC[D DEAD <br />ONOUrKfDOfADlN•r <br />H .. <br />/� �� CSlfra•. <br />D.P. Y..r <br />r <br />7f► <br />n I <br />/a" YG <br />• / Cam' CCfA `r <br />2,S, <br />•�__. « <br />1 .Sf <br />pC —__L <br />r...... 3,j� <br />+..w «. «..A w <br />l# - <br />!'.r'R'ir1 wl�i� �. A..A ... . w.. <br />w .I «..w ; <br />S.I i ! <br />n°..."�..�A.....i rw.:..� <br />�]A• It...«..n N/ r_M� <br />M s'�'...r.i ....:.'•«... <br />.. .. <br />( <br />.itgw•M• W Twl•I� <br />S 1fR I T InN. COIONERS <br />/CIAN OR COUNTY AITO /NETT f t, /. « F"Mr <br />Richard Fruehling <br />�...� <br />I. p`f fff <br />/I.ftrl�1•"'•SL S /`' <br />M.D. 908 N. Howara urana tsLai KfIVtDETlEvRTRAR(AI..,D.i , r.) <br />„� FEB 18 M6 <br />rr 05Q# CAUSE ,f LINf_F-W f.l /lYL AND 1.11 I'°"'I aI•"'w�. r"�•e',•°+ �A <br />^^'► ��1�' 1 L.i/% -L - <br />ASAC <br />Iiw.�..�rw...w <br />DUI to. W AS A CO«SIQUINCI af- <br />. <br />N> <br />- t • <br />/yi- j�rN�/Y�1 — r.'•wr <br />I- -_ �y <br />w I <br />r ESY ]f C1ROMf <br />MONCY w NI PAST 1 d <br />rH <br />ZD}N�D <br />HF� <br />s.J, 1 _. N« <br />I- <br />]t <br />! <br />ACCIM.R. SIIIEIM..r,rfu. 1 . RATI a NUURY 1+.. U•r. r• 1 wOYt 7 iwu.. rNKMt rrOV Ir.111tT OCCUtNO <br />a P11.1hoom ■nRNIDAIION lyryI <br />SOR <br />130. <br />iR. .tom! a•.�- « w•. 1 «� w .., l.w. ..�- trNIY q I r D Ir Cm p rO.M ISAfI <br />i\OLAIgNL <br />to MW A�r. <br />J <br />a <br />4 <br />