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STATE OfNEIIIRASWI — DEPARTMEHTOFHEALTH 85_ 004337
<br />•UREAU OF VITAL STATISTICS
<br />CERTIFICATE OF DEATH, ,
<br />NAM - -�Tlit MIDDLE -'- T SEX r ' DATE Of DIATN (Me , Ow,, Tr.l
<br />rlartha C Duester Female November 16 1 82
<br />WbiN. Spe <iy) GMOS. GAYS
<br />NO K NS1
<br />zilte l O11 S1[ M. 82 bb Ib 17. Auiz.-
<br />&AND
<br />CITY A ! Of BIRTH (M wet iw U.S.A., CITIZEN Of WHAT C0UNTRT HARMED. NEVER /AAIRIIO, NAM[ d SPOUSE (Nark, •in wrord.w
<br />) WIDOWED. DIVORCED (Sp «iy)
<br />USA tD. Married ,, Fremk Duester
<br />Al
<br />MTY USUAL OCCUTATION (Gi.e kind l ei d di N RIND Of BUSINESS OR INDUSTRY COUNTY Of DEATH
<br />d wekin hl eTe)eNfed) /�Q 8-0 2 17e homemaker qo Home
<br />tab I.. Hall
<br />CITY, 10WH Olt
<br />LOCATION OF DEATH lHSIDt CITY LIMITS HOS ►ITALL OR OTHER INSTITUTION - Na (If nor in .i<Mr, N Nosy ot INsT I.d.... DOA,
<br />(SPKiy Ye, e. Nal •iTe lhwl acrd nuwbeq 0.N.I:wRwN M , I.ry,..N fS•NMI
<br />1 Grand Island I.C. lea Ibe�t. rrancis Med. Center ,.. In atient
<br />RESIDENCE -SPATE -'�- ---
<br />CITY. TOWN OR LOCATION AND NUMtIR ';,NSIOE CITY LIMIT,
<br />jcOuNTy
<br />' �ISpe<rI YnuNe)
<br />is.. Nebraska Ball is.. Grand island +,sd 0 East 2rd St_. Is. Wes
<br />A -NAM MI l 4 MOTHEf- MAIDEN NAME fl S MIME-- '- �lA�['T
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<br />141. FZank Curtis 17, Julia Nendyk
<br />WAS DECEASED Evlf IN U.S. ARMED FORCES? j1NFO%MA NT-NAME - •RELATIONSHIP - MAILING ADDRESS (STeftT 0e f/ O MO. Cln Oe 10— STOP. t.1
<br />. Frail Duester-Husband -509 jte� :rard Isl n.21e,
<br />BURIAL. Cr•w.Nen, R•wo..l DA MA C[MfTFI Y 01 CRETORY -NAME ) IOCA/ION CITY OB TOWN STATE
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<br />SIGNATURE IKENSf O.
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<br />I FUNERAL NOME -NAME AND ADD fSS ISTRtO 0..1 D NO. CITY M TOWN. STATE fob
<br />lies 68801
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<br />DAT! OF DEATH fm- De,, Tr.) =w
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<br />NAM AN S M ( SKJAN $ PHYSICIAN CHI COUNTY ATTOINEYI f lip, or Pnnr/
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<br />• 0 Pierth F.oward Ave,_, Island 'te. 6880"
<br />twAbeAA DATEJFCTrvED By fEGISTRA! fMO. Dar. Tr.)
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<br />r:71ASMIDIATI AUet (fNfER ONLY ONE CAUSE TER LINE FOR la). fb), AND (<))
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<br />I. Cardiac .1 rest
<br />DUI to. CA A& b rom46itimce Orr IM.nN bNw•+ •w<w •.d d••M
<br />M Cardiac srrhythmias & bradycardia- and arrhythmias
<br />OUt TO. Ot AC A CCINSEOUINCE OF r on.1. c congestive 1 C' a l" t . a ). l: F70-'
<br />,,, iibrill_a'_ ion & ischeni_c heart disease.
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<br />130f.
<br />Ft,KI W INIURT - M Awe, lefty, 110CAlloN Staff? W f 1 —6m. - - - - --- (ITT pe TO— $7.11
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<br />WH%N �ZPA,*ZNT".OF X' x 6017, PARRIES THE RAISED SEAL OF THE NEBRASKA
<br />S?S!P?S HEALTH, IT CERTIFIES THE ABOVE TO BE
<br />ABC S_ CORY OR- Alt ORIGINAL RECORD ON FILE WITH THE STATE
<br />DEijl$TM N ,,.OY REALTH, BUREAU OF VITAL STATISTICS, WHICH
<br />I3 'SHE L AL Dr OSITORY FOR VITAL RECORDS.
<br />DIRECTOR OF VITAL STATISTICS AND A.`SISTANT STATE REGISTRAR
<br />LINCOLN, NEBRASKA Issued November 30, 1982
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