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WHEN THIS Copy CARRIES THE RAISED SEAL OF THE NEBRASKA STATE <br />DEPARTMENT OF HEALTH- IT CERTIFIES THE BELOW TO 0,--A TRUE COPY <br />STATE aVXnjqWT VF HEALTH <br />E <br />OF AN ORIGINAL RECORD ON FILE WITH THE <br />STATISTICS, WHICH IS THE LEGAL *aosrjlGU - FOR <br />BUREAU OF VITAL ST <br />VITAL RECORDS. <br />how <br />DATE OF ISSUANCE <br />MAY 2 9 IM STANIM S. CQDPlM,_-j DIRECTOR <br />t' <br />BUREA,C Gff - V JTJ :STATISTICS <br />LINCOLN, NEBRASKA 0038FS <br />STATE OF IMMMAW- 9WWAT10111 OF MMIN <br />9mm OF WiTa SuTtSm <br />CERTMATIE OF DUTH <br />!.-Fty 7, 19F' 5 <br />CHARLES ROY OSBORV male <br />U#4m 1 DAY :WE GVSINT«'A D., <br />W oft' oj_"k cli mos imys <br />'july <br />.bale_ y American 72 iam-1 cw <br />I. lcfflzew cw ~I I- <br />cy" *AM �S - _" (w 1 <br />— <br />0 O- F -o--u - ---------OR -v-W-Um'21 U.S.A. - <br />iJ=LkwuSuAL OCCOWA (G—*-l-#--" "-I � Cohsker <br />i <br />00- 139 1 mtj S ub UTIO. - <br />zm Lw�b <br />S p­ cl Elk <br />land, Nebraskal'.' es .d 11? r. en St <br />cm. OWN cm LOCATIoN �j <br />Tilden St. <br />kEL !,s_bHall �,,Gr—L Island <br />. <br />.r <br />Roy Osborn 17 Ag <br />nes <br />was victim Em w u 5 ;W--ooaafw INFOW^^"T <br />Z -No- ;15,'pauline (,)sboj�r, <br />.�i�e_11-4 F. Tilden G7._Ln_d 15_� <br />CiTV70a OWN STATE <br />cu. 7cw" LOCO-11CM <br />L. <br />MI �1, 19835 Grap <br />Buria2 _d I <br />_slt�d_Cil�Y_ - Ce!qe_tery - -_mod 2w <br />46Wi - NAME AND�DMVESS (STOW 0. iUNNAI No <br />_LijLinston­onderm r­ 0 <br />K�enij�,,Qramd Island. ?ee. <br />22 DATE 540MV <br />Dom of MAN" (mk�. 9". V.-) <br />g%w7' 19MS5� <br />0 <br />1IV <br />z3b Mir 10, 1985 5:30 P.m. pA <br />d <br />..d d- <br />OUNTY A"COMY) I FV� <br />C mc <br />-129 k._guster, Grand Island <br />_ <br />omy own c lb), AND 1, <br />10, of Is I —comiew"RE, <br />T — ---------- w <br />#AM <br />amm" v "uvw N.P. a". I- OF <br />cii; w f5w.; <br />f6p.*T­~ <br />