Laserfiche WebLink
RQ�� 103042 <br />WH%% 'IHiS C(itV CARRIES !'RS -AISED SEAL OF THE NEBRASKA STATE <br />DZpAR'i'ftaT OF HEALTH, IT CERTIFIES THE BELOW TO BE A TRUE .Copy <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMOT OILHULTH <br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DEPOSITOP 'T OR ; <br />VITAL RECORDS. <br />DATE OF ISSUANCE <br />iu.4 j 190F STANLEY S. CO DER <br />DIRECTOR <br />i <br />LINCOLN, NEBRASKA BUREAU OF VITA'STATISTI�C,�S <br />n' . sf_ -.IL.- <br />pits. Vs) MV. 4-57 STATE OF NEZZASKA <br />IDtpAilalnEntr or pvLr Iizwt7Tt. DZrA1MMFNT OF HEALTH <br />nour�TtOfE AND W10E.FAIIL .,.-- ..1 V1w slati$ks <br />i <br />Reg. of Deeds <br />a,i nij oaa <br />I "twtxtt tto 125. »» CEATIFICATE <br />., <br />OF DEATH sT.%TZ r " ry _.� ..- ..._... �.. �— w- ........._ .. <br />.. <br />L <br />wi11AL wsi/RtwiE (IA.. Lr...tii�t. u:wt.+....• Ir.a..r.ww -- -'- • —) <br />1; f "AT" <br />A, STATE a. tAURn <br />coww" - �� D <br />k... CRY. TOYIIL.OR ►OCATg11 <br />C. LENGTH Of STAY ON to <br />!. CITY. TOwIL OR LOCATION ,. <br />-A Tq1 <br />t. NAME or (if hkttllnlr Ikf ANMt A/MANI) <br />/. STMLT ADON[SS <br />IICS/ITAL 00 <br />1 <br />wp$T qN <br />I. n A[SIOEPCX INSIDE CITY LIMITS? YES f. FARM RESIDEMC[t YES <br />t, ,f ILACE 01 DEATH 01S" Gn LIMITS} YES 110 <br />MO <br />]. 11A�K'. 4W Ifltt: Atudk LOW i. tort AftAJS Dow Yaw <br />KCEARO DEATH <br />17YM r /tiRtl <br />���TT E DATE OI NOT" S. AGE IlN /eMt YNRLi11 IM[R H irlt. <br />SEI t COLOR ON Abu T M.*Mq J NEVER WANK* NI( kkM/A►) AI.NA. a— Mww Ariw <br />6 al` <br />White TNOOw[D ommelD <br />_ f OJIIIN P Nil} ODWHITr <br />)ON. U.iy CCUy 10►. NAIOO/ousuluSONR/DNfTRT It. NOT ($W Mf�MtMifMMr/1 <br />lA1 k%t.ewt Jjtwbtor <br />13o. fATM[IIY MAYE IfY.NOT AY 110CM NAME <br />K NAME or NVSRANO OR w11E rd R- villor <br />LIEC[ASE0 [V[A m V. 1 AAMED tORCIISI K. SOCIAL SECVINTY M0. <br />17. M/wN[SAATT A//rrw� N • O k <br />I'Iand, Nsr. <br />""'� None <br />Edward H. Hiller Gran(i <br />no <br />NITMYK RCTIt[[M <br />• <br />U. "Wt M RRATN ILa w sell ~ cabin pw J' N). 1A). AR/ 4c).1 ND M <br />PART* D[ATM WAS CAWXD M+ <br />` W"C"TE CAUSE (d <br />/ � X ✓ �� EµK.�.v <br />G1rR/YIrAt. r/ mr. DO[ TO ( 6) <br />iAkkA.INM r1A1 <br />• 7 1r <br />Nlwr twee . <br />.. HrfR1 W r ed. 1 WA TO (r) ► <br />PARTS t�Rat led. ) WAS AUTO" <br />PART M. 011Y frEli/KArA COAM ?IOUs CONYAI,1(M 70 D[AlN M 1iOt NpATti ID M 1[M1RML ONGRL OpriltllpN flYlN M IAA? HAI I[I11011NED/ <br />❑ !r0 <br />iDA. WENT ICBM X0 OESCAIK NOW wNINTOCCVAN[O. 1 AiNNry .JIN}r? part IM IYt of Kktw JIJ <br />❑ .� -❑ <br />>4. TNK Oi Jt/OAM, iIA1. Yew <br />RIJNRY A. I <br />�- <br />E <br />IL i--"_" <br />OD11Nn STATE <br />y <br />1 <br />mt. MIJIMIY OK11M[O <br />pr. PLACE OF mHINY k. I.. iN M RAtNI br. <br />7dJ• Gin. TOWN. OII LOCATION <br />. <br />WNILL AT ❑ NOT THIN. <br />wOA1( AT wOIIR <br />- 1r■o. /ANt?r, ef/Nt. �N pN1., ML.1 <br />:1. I Rta.rlOi the t.aAwl f , f1 RNI r�At pw AI dr.. ow I i2 <br />to the *aOt or N11 kNAW/OAd*. IrR.N tM w VIN AtA /AI. <br />Death KAMrtOI At 10 m, M tM.AN At N A/1.V.: Aral <br />Tot. DATESKM <br />(Der r Ik) T]O- u /O <br />Z <br />I" p <br />I <br />IL wiNIIL.C1E wow DATE 13c. root Or C[N[TEAT oil CUM Y <br />l Park <br />i1/. LOG ION (Cli1, hv+. M eMM11 gam) <br />Grand Island, Nebraska <br />in 4 -21 -1962 eat wn Memorial <br />N. DAn NCR. DT AEiIsNM 7S. <br />MGajIN' SK'NAT L. NAME OF MORTOkNT A0011[Sf <br />Butler - Geddes Grand Island, Nebr. <br />APR 2 4 1962 <br />J(J Ivfel- <br />�f <br />._ —.jI <br />