|
;I
<br />l
<br />STATE OF NEMASM- DEPARTWNT OF HEALTH
<br />�V "OF VITAL STATISTICS S� 020
<br />2 5
<br />000373 CERTIFICATE OF DEATH .�� 3(,
<br />Filmy _
<br />Sf11
<br />DA I EA N (MO.. Y. Y•.J
<br />Arthur William Sanders
<br />��Male
<br />,.February 11 983
<br />WAito, tlmTl. Ao�Tnuw OR,GIN(DESCENI I. 0. Iru1;w . M.'ir®n, AGE -sea trw•Anr
<br />UNDER I —YEAS UNDER 1 DAY DATE OE IIRTH (AN.,
<br />A.d:ew, nkJ(S)T.r;fr) G.r�sn..H)fSp «dr) (Yn.)
<br />DAYS HOURS AD
<br />.White ,. American 8I b6
<br />rS.
<br />,. September 19, 190;
<br />CITY AND STATE OF SIM (9 Ae1 .n U -S A..
<br />CIT11111 Of WHAT COUNTRY MARRY , NEVERMAREIED.
<br />NAME Of SPOUSE (N.U., Situ__.. wow,)
<br />A.w. ro-.b 1
<br />t. Atchison Kansas ���
<br />WIDOWED, DIVORCED (Spni(r)
<br />E U S.A. to. Married
<br />IT. Mary Cihlar
<br />SOCIALUCUSITYMIUMNR USUAL OCCUPAVON IGi- Iti l.1-1, dew d., 0 KIND OF BUSINESS OR INDUSTRY
<br />COUNTY OF DEATH
<br />o/.Mliwp fl., non A.0inyl)
<br />1,.5(6 -09 -4829 , Chief EaBlneer Iw HoB ital :'
<br />1
<br />1 Hall
<br />CITY, SOWN OR LOCATION OF DEATH INSIDE CITY LIMITS HOSPITAL OR OTHER INSTITUTION- H.- (N not in *A*,,
<br />HOSP W MST IwOk- ODA.
<br />Inenl - -40
<br />JPF
<br />Spe , N.)
<br />(,d. Yen Wi l n Nursing Home
<br />Inpatient
<br />1411, Grand Island, Nebraska ,.d. w&A
<br />,...
<br />NC! -STATE COUNTY
<br />CITY, TOWN Oft LOCATION
<br />STRFET AND NUMtfR
<br />"SID! CITY LIMITS
<br />ebraska Imo. Hall
<br />,k. Grand Island
<br />IS/. 310 West 4th
<br />;es nom'
<br />- U
<br />HER - MAIDEN NAME FI T M1
<br />Freak Sanders
<br />fA
<br />„ Elizabeth -- Barr
<br />S DECEASED fM IN U.5. AIMED FORCES?
<br />INFORMANT - NAME - RELArIONSN)P- MAILING ADDRESS ISTRRI/ on ■ r D r.o. UT' oR tow". STATE. isry
<br />No ',,Mary
<br />Sanders - -310 W. 4th Grand Island, Ne. 68801
<br />wife
<br />BURIAL. Cl~i -. It"'n I
<br />I
<br />CEMETERY OR CREMATORY -NAME LOCATION CITY OR TOWN STATE
<br />m..Eurial
<br />,pb. 14, 1983
<br />,D Westlawn Memorial Park I,odGrand Island, Nebraska
<br />I -S AT f NO. +r4.� !7
<br />FUNERAL HOME -NAME AND ADDRESS ISTRIET OR R F D. NO.. CITY Of TOWN. STATE, IN)
<br />: ` /'
<br />r
<br />T2Apfel- Butler- Geddes 1123 W. 2nd Grand Island, Ne.68801
<br />DATE Sf NED (M.. D.Y, Y. 1 HOUR Of DEATH
<br />25..
<br />DATE D(M.- D.Y. Yr.) HOUR DEATH
<br />jO
<br />PRONOUNC ED DEAD - - -- PRONOUNCED DEAD IN-)
<br />o
<br />j
<br />,
<br />�1.."SIM..DaY.r,1
<br />23b. - 23.
<br />I ... b- AT - -O6d10o. d.. .... a• N .n. �
<br />rAwAlr/ w.r.R /
<br />� .I
<br />i= ]d �zd/ IT
<br />. .. -. d.N o•d sM !.• .. n.. r •.HU ,+A•N
<br />.(SvnAM. Ad i+f"
<br />al.r.
<br />I Ada rS,ne.,n sn/1N.)
<br />._rp-. ____ -_
<br />AND AODtE t Ift (PHYSICIAN, CORONER' PHYSICIAN W COUNTY AlTOt_�T
<br />o, P•.nt)
<br />C.D. McGrath M.D. 729 North Custer Grand ISland, Nebraska 68801
<br />2�7.��; :.� �'��• lam, ,
<br />�3 -$ —U WARATI CAUSE � (ENIER ONLY ONE CAUSE PER LINE FOR (a) Ib,. AND I.11 �..u.wt e..w.. Aw. •.. dw+e
<br />VAST /
<br />O. ON AS A COHSE ENCI CAF. .nlwnT, 6r..AA• .•rH A.d d..�-
<br />AA LAIL 46&
<br />Gii4 �Of Ai w cdESE ®UfNCf W: 1 6a..A.a «w...d 4-0
<br />--- -
<br />P, y, �dtwi' sFu.T��TanroFn- c«en »•....- .6aIM, .. e..+•e:�
<br />^IIQ
<br />R C U 1
<br />1
<br />o - -- - ---- - -- -
<br />�« �.i.ne ..n -.0 a Ie.••Ae w IT. ee/ • •urOri+
<br />I,EGNAIK. IM TH/ r•8T S•.Onlnsr . s,:«d, tw « Na)
<br />rr.s uu Ren,teo ID )MpcA1
<br />ElA `1 1E q coRONIR
<br />!79
<br />.ccloa � poMKW�. IIUHB[ DATE OF INIVIT rw. D., 11 •,
<br />OR KNSe.s'YEENOAItd, d1)
<br />__LZE
<br />ITHOUt a iNluri --- +(Muref How Iwun
<br />__
<br />OCCufto
<br />_
<br />PLACE OF RNWT- A. 6w IA- .nw.. l..
<br />..0 ►l fPLACE"MJUTTV ��._ _._.._...�l��l�siglT
<br />rss«dr •• a Ns1 y AHp 6•.Adi.s .t rsa«dr.
<br />of R1IT H.
<br />C,n o! To" STAIN
<br />� ]B1
<br />7
<br />__j
<br />Imo,
<br />I
<br />
|