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oc <br />054. 006111 <br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA STATE <br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE.A -TiWE COPY <br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DOUMT—MM-i,`"OV-NTH <br />BUREAU OF•VITAL STATISTICS, WHICH IS THE LEGAL D.Ep6Sfj'dkY" <br />VITAL RECORDS. <br />DATE OF ISSUANCE f <br />APR 3 19ffi <br />STANLEY §..t;-f-oOPER <br />DIRECTOR <br />LINCOLN, NEBRASKA BUREAU OF VlfAL,-S.TAg'jStjtS <br />STMAV1110MA MM- INMAMW OF UMT91 <br />4� i VnK STAIMM <br />C=T aF MATU <br />ow W, M <br />7 <br />