|
WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE',A TRUM Y.
<br />OF AN ORIGINAL. RECORD ON FILE WITH THE STATE DEPARTMENT OF HEALTH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL DSPO$ITORY FOR
<br />VITAL RECORDS.
<br />DATE OF ISSUANCE *m-A
<br />STANLEY x ,OOOPSR; D1REC'TOR
<br />LINCOLN, NEBRASKA BUREAU OF'VCi ,STATISTICS
<br />- ----M - 105021 T
<br />STAT[ OF NEMASKA- DE/ARTWW OF NMTN
<br />BUKM Of VMAL STATISTICS
<br />CERTIFICATE OF DEATH
<br />Dec[ NT -NUME n - DA DEATH jiY 0-. T.)
<br />Lamonte H. Sapling T Male July 30, 1986
<br />RACE -tr.R , wlrft Rbet. Aa«:ts. ORKi1N/OESCEMTir f Ali +•.lMa�ww, AGE_t..e r ", UNDEE 1 TIM UNOR T DAT DITE OFtrITMtw.. Wr -4 -
<br />l.r. -..R y! c.,.,..�Irs- I try, Imn, awn Iwur�s, „DSS
<br />1° to S: American � 70 aa. a, T_ Aril 10, 1916
<br />AMD ST.tE OF RNTM (k r1:. U.S.A_. CT1tTENQ+rINAf COVNTRf M MARRI[O. TEAMl OF SEOUSR ttr�at,.�,w as:Asw wewY)
<br />ftoIOOWEa. DIVORCiO tSrriEEt. -
<br />Adams County, Nebraska E U. Ala Ma II, Johnson
<br />LL SfCUR;;T NUM{!t US'!A! oCCU►ATI4N fG+s t:wl d w.t dbss d..+y .sa rwQ OF RU3foot Or INDUSTRY CWNTT OF
<br />id+A1
<br />IT 506- 10-7007 Farming (,x,- Agriculture If.. Hall- '. .
<br />CITY, TOWN or IOCATiON d DFATN — �XSIDi GfET (Wn3 MOS11tAY 0E OTxtr MKT11UTiOM- Iisw. iSw«:. adrr. +T e,wr+dL++r!
<br />q:...w.+a.d...r�..F
<br />,.e. Grand Island �I s..�r, yeS «..ri1. St. Francis Medical Cei atieut
<br />RESIDENCE -STATE COUNTY ram Tow" 01 toCI fo" I STREET AND HUMREt _ Ni310F f7n tvmn -
<br />+S, Nebraska Tsr Hall ! IS, Wood River +S. - RR 12 ' aotl
<br />FATHER - Mfr -Mw NNAME I
<br />, John _Henry Sablin , Minnie - Kate - _ Haselbarth WAS MCFASED "" m U S. ARMED- ,QRCFST . i 1NE00,"Aff -NAME - tf[AT DNPW MwltiElfi ADDtSS RTtTI [M r, n W .CRY CM TDMM. TfATl. 1M -
<br />,i Yes iWWII 3/4f�+3- 1/1.3/46 ,f Donna Sahlin Wife_�'RA Z Wood River, Nebraska X883
<br />BURIAL C...ef Rrwo el DA - f CFMif[RT OR t:REMATtMf _ NAME _ { 1OG710M Cal or (OWN STAIR
<br />ial TOSAu st 4,198fi 'IO Kenesav Cit r Cemetery ITtw Kenesaw. Nebraska
<br />. UCf MO. - :EYMHfAINOME.- NAME.wNB ADBRFS3 ESTte ORr,R MD. C—p IDwK SiAiE l:Yt _
<br />Jackson- Wilson F.H. P.O. Box 6 Keitesaw We. 6895.6
<br />Ow fM.- =,IOw t1F DfATT1 -
<br />IFATF DEATH Oft D.f w.t. _ r i -
<br />(( A y/} I {la., Ae,, T.1 - A H ice EUrRONOUMCEDD[M.__` `rrONOVNCED DEADiM.«!
<br />vv I w1.0._ t - ,C OR CoUH ATFORNEV) ft= «v! -
<br />Dr. R.H. Fruehling M-D,, 908 N. Howard, Grand Island, Nebraska 6M03
<br />- --• --- � , _ - IMTE R[C
<br />AUG 4
<br />7SUG 1 1
<br />-,_ f 1� A SF (F1iTER ONE C RR i1NE E01 }- . iit. AND fHF .. Asa-
<br />Cf} A9
<br />.. Put 10. OR AS A�GO,N`S,EOU �f �O�f,�,j�� j �%% �J)g �� _ - _. rw...i ►...w ..r:.r �..+,
<br />DUE t0 OR AS -A comeONEMCE OE-
<br />PART yti� t"^ ri..�y ��NH3,MMC�MIflt ►AST,S+IDNTIIS, �S Y. ,� WIW9 as COrOMp
<br />- KORtMf. S111C1r[. tM,plT -_ -: � RASE t1t wiwitl tM,: t I,tI11R, �iw[MF +10w PYURT aCCYtRO
<br />Or tVlRr,i r,YTSAGtIDN- (S/rdf3 a - S
<br />_ 70W _ >Q M ; sor -
<br />Is,11rT V 'Ot < _ -0F t![M,- Mfrs. ,rw. Me..e.,«w., iDCalNif FtR W it 9 Ms.—. >. Ct1V -OR Tnwlt YP� Tt
<br />i(trw,,, ,w N4 ��Wwil«GiMY,.h iSwe,,i
<br />NoIi_heast Qua ter INN/4, --,-)f Srsztl9r,
<br />-i''s., Range -- leve,n iltit Wes, of _hc- ,h P.M. Ha-,
<br />I _7 'C:.)i:11t_ '"vt,C_r -I t,;. ,
<br />T
<br />Section hi.rt (.?t. ) 'f?umshl inn (9i North, Ra nc;e A iS?'ien we i.
<br />c:,f t):er 6th P.M. , lilyll County, Nebraska.
<br />
|