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<br />83-001495
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<br />John
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<br />U$wt-NCE-stA.U ICOUN1Y
<br />,1.... Nebraska 'j,,", Hall
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<br />Grand Island
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<br />WAS OfClAS-ED tvEit-IN U,$. ARMED fOli!C!:S'? 'IH-fOR-........N'f N.t.Mf - RftA!IONSHfl' ,MAILING ADDRESS {SfUU' 01 ..., tf NO;. CIty O' TOWN_,ST....n, Z"t
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<br />,. No i "9Xr . Steve Fleharty-Daul'htpr-1409 'Pionppr 1\1",\ _Grand
<br />.. 6URl,-.,t, Cf_,liOl'l,.'-I'\IOVOf!DDeC.. 20, 1982 jCfMElUY OR CRfMA10Rl' - NAME {l.OCAnON CITYOUOWN STAn
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<br />I ",", Burial!<Ob I,,,,, Westlaw-n NemQri'!-)'J'.lu:k_~rnnJ;l Island, Nebraska
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<br />! NAMe AND AODaus 01 CUTWlElk'HYSICIAN. cdtOtllrg'""lClA.N oa COUNTY .nOINnJ lr~p. or Pm"}
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<br />~" Robert Koefoot ~1.D. 7~7 ~.. Custer, Grand Island, NE. 68801
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<br />Out 10, 01 AS A CON$fOUtNCf Of,
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<br />John
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<br />Frederick
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<br />!Crabe I
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<br />}!ary
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<br />Johnson
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<br />tla',!!,.~. T,HIS cm','iC",ARRIES THE RAISED SEAL OF, THE NEBRASKA
<br />~~E ~EPA~T~~ OF HEALTH. IT CERTIFIES THE ABOVE TO BE
<br />,~~ :'l'RUE ,J~QPn~~;;' AN ORIGINAL RECORD ON FILE WITH THE STATE
<br />'~,,', .~T~.t.,N~,'~,~'aE,' ALTH. BUREAU OF VITAL STATISTICS. WHICH
<br />:t)-:lftti.. ~,.~<,DBPOS ITORY FOR V IUL RECORDS.
<br />',f'~:'f':::-'~"( ... JA.~ ~~
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<br />DI.B.ECTOR 0," VITAL STATISTICS AND ASSISTM'T STATE REGISTRAR
<br />LINCOLN. NEBRASKA Issued December '27, 1982
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