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WHEN THIS COPY CARRIES THE RAISED SEAT. OF THE NEBRASKA STATE
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO.SE- A TRUE COPY
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMENT' IREALTH
<br />BUREAU OF VITAL STATISTICS. WHICH IS THE LEGAL- DEPOS IT-4i n OR .
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE
<br />A N STANLEY � S ?COOPER DIRECTOR
<br />LI:3COL14, NEBRASKA BUREAU OF VTTAL S�'�ISTIC5
<br />STATE OF NEMASNA- SPARTNIM OF HEALTH
<br />BEAU Of VITAL STATISMS 86-102797
<br />CERTIFICATE OF DEATH `-
<br />_b1Z16IftT_- MAW
<br />Rufus _ Lee Collier 4 Male 1LJanuar 10, 1986
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<br />t ___ — DAYS t NOVAS ; MMS J Ma 13 1928
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<br />Mounds Oklahoma . U.S.A. ito.Harried I1, Sally A. Farrar
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<br />RUGIAt. Cr :,*Sally Collier Wife 622 E. 12th Grand Island, *1e.68801
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<br />a� n. 13 1986
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