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<br />STATE OF WYOMWG
<br />rUMLDLa CERTIFICATE OF DEATH
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<br />DATE OF DEATNIAE.., D., Y-Found
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<br />A. July 1. 1923
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<br />STATE OF WYOMWG
<br />rUMLDLa CERTIFICATE OF DEATH
<br />85-- 00029:
<br />LAST
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<br />DATE OF DEATNIAE.., D., Y-Found
<br />KEITH LEROY POLAND
<br />E_Male
<br />', March 3 1984
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<br />A. July 1. 1923
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<br />A. Nebraska
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<br />». Married ,,. Helen Marie Foster
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<br />CITY. Tom on; ali�a STPLET AND N{AIlQER
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<br />Hall
<br />,k. Grand Island 3220 West 16th St.
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<br />FAMR FIRST WADDLE LAST
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<br />AK3T.ffR- MNDFNIW�� ctR,ST N�D[E IAST
<br />,,. Emma Sisco
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<br />mAkmopDDRESS sTlwE7f .FO NO C O"To— STATE rr
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<br />Helen Marie Poland
<br />3220 West 16th St., Grand Island, Nebraska 68801
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<br />OTYIEI11y�,.nJrl
<br />,ft. Removal
<br />,o,. 3 -4 -84
<br />Ems. Ord Cemetery
<br />TiF. Ord, Nebraska
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<br />F AT 1900 E. 19th St. OWES ov
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<br />E awFE (1F ATTEND®tDF rs CUw If OTHER THAN CERTK ER T.f .•!'nnI
<br />EV FltomouftCED DEAD IN. 1— 1•-
<br />PRODDEAZ,ff —+
<br />March 3, 1984
<br />no. AT 10:45 a. ■
<br />T�A141AW 2.1�IA t.Tn.nrcwrrn,aw.w. �...wnvcnl "..P..r.n.u,
<br />Roger W. Radomsky, 1900 East 19th Street Che enne Wyoming 82001
<br />ROSSTMR ^ / / OA:E EiCENED ®r REGYSTPAR %Y.. 1%, }' -,
<br />�. wwEDVIT -CAUSE IENMRONL rONE CAUSE PERGwM FOW Wl A/A'.(c/l luwra 9Fa..M awIINCb®+
<br />Acute coronary thrombosis, right posterior coronary artery Unknown
<br />DOE YO.OR AS A CONSECPAACE OF I avKN B.G..w+tMR MW O.A!
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<br />Severe coronary artery disease 1
<br />DiAE TD CY1 A5 aGpraSE[MNr.Ga �Irn.rraOM.. ^mmtam O.err
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<br />� OTItER Slayacf rCIW4 CGRIGmTrONS <Ogacna m.¢'Wr^ivO.6�`MR .aa.MN9bcuu pM�nPART i;a; AUtpPSY. \gr.�h l'r. ViAS EAST. REFERRED TDCARSMIffR
<br />ACC sUcM WW UNOt' DALE OF myplpiv Y�. !Nr 1'• 1.1?kllf / \'JI'AI" IDE�r'RINf H". I'll .1 l.Y Y'I In",
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<br />MMIRY A7 MI" DACE('MAMT -Al Maw'— RN/. 'ma. WK —9 lbUlttHl 51REETOIR1 0 W CATV GM TDNM $TITS
<br />Date_; I -ssued April 6, 1984
<br />THIS IS TO CERTIFY that this reproduction is a true copy of a record on file in
<br />Vital Records Services, Division of Health and Medical Services, Wyoming Department
<br />of HeaVth,dnd Social Services, Cheyenne, Wyoming.
<br />If this copy does not bear a raised seal and the signature of the Deputy State
<br />Registrar is not in RED, this is not an official certified copy.
<br />o-v
<br />Lawrence J. Cohen, M. D. Richard 0. Hall
<br />State: Registrar Deputy State Registrar
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