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STATE Of MEEAAiRA-OEMRTM[NT Gf NEAtTM • (^~ OO 14 `w~ 1
<br />~IMEAY OF YITAk STATitTICi
<br />CERTIEIC~TE ~ DEATH' ~.~.ann A ~ a s s n
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<br />-DNtDlM-NiMf __ iiaET-__ _.._-_. ____.M~6[i'- RN.; I, Yr.)
<br />i~9arze i°'ar r t ;1' Female Aril 28 'I 80
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<br />.. :off l~~ces•iean ~`?~ ~
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<br />wvoowtD. wwtc ea Esr.•+rt
<br />a""'~al`Y CounC iVE. 1,: U.S.A. , . 6J.3dowed ,,.
<br />soeuEtrcumwwwa uwA(ocf:orA(wNrcr..iMneeeMr.Peew:.a..r EMIR«wsDEeas~oaaEW{rar couNndwArN
<br />,~5Q8-3t?-~i816 .l..M;eE~~ousew 4.e lsr, it m is :
<br />tiTE,rOWNdwcArawd MlTN i!tNflDt Cttr IDMITS N(}SNTAt O[Q(lit{IWYtry(NHE-Nr-(K.M iPeiMir: r'rN1ER. pIN{f; yyey ppA,
<br />Gra.'Rtl. Island i{sP"~X .rNe1 E;ww erP..E..r a~t...:...,wr..rs:.w)
<br />, ,.,. e:= ,b_ Lutheran iios ital r n
<br />tta,De[ce--sTAr[ covNn CI1T, tOWN pE 40CAi101( sitEfi'AND NYMNt yNy,pECiry iyN}S'
<br />{s r„rNy
<br />l~Jebraska ,,.. Nall i,s< Grand Island ,>a. '16 50. S camore ,,° ~es
<br />-MAIDEN M E
<br />John i,einrich .+eu~ert „ tstieoke - A~yen
<br />',+AS OECEASFD Mt /N U.S. AaMED IOEC[ST INNZEM.NT_N.Y,t_EEt4[/ONSNN- O TRNT 0. ND:.,Gip,q~[pJ[N; (TAtF, t
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<br />,a- ~o i,~~3rs. i:ir~er I;zoberr-dau~Ytter-"~iEieSae ~ eamore-
<br />au[nu.c=...Ne,,,E.re.elDAr April L(AUr(EYOtn[.urwr-NAMe tourNla LmoE.rewN stwre
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<br />,D, Bu °ial ,Db +~s~ ,otsrz:nd Island Ce:aeter~ .:D. Grand- Is~.~nd h~
<br />-E/Ci/AIIrNE ENSE +~{M.~ ~v .l ~ iUNEiAt NONF -NAME AND 4OD[[SS (A1E1 D. L!m MD_ (/jY.pt ]pwN, Sj.Rl:. Fi(~ n
<br />n ~: , ( j ~„Xa?`el-sutler-Geddes '1123 W 2ri~, ~~ n Ise end
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<br />[se.< wrwel~ ! ..~~~- ~z rl;o.w.+wrreu-
<br />W roes (Me., Dnr, Y,) ;NUtiR flf DE}SN_ -~i~~ ,Ay-
<br />3 1:a-. ~'~~q~~'0 'rte _f 1~1~ M ~ ~i F~tJb. IR{c. M
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<br />jDAIl Of MAIN{DEATH W„Der, •eA ~---~~ ---~_~ Z V fPEONLIUNLED DEAD lapNpUNLEO DEAD{New)
<br />_ . -. j,jW- f 2M M
<br />N- s~E~i Df ~~fTDiF fij-~~ N~tCIAN. CQ~ONEE'i M4YLClAN f71 L~UN{F „~Tt()h!(Y) t IYPS e. !'e,.rl
<br />K'~"cus..u L ~;._-::tes= ._ ~`'0 t°i, i;i °isian Grand Island, i+F. ~~,ir3G't
<br />~t i ~- / ~ ' DArF a[CEEC a. t(msr {Me., Derr a
<br />u..rw,»r,w- ~ '~ ^ ~ .x~ , . r~x ,.:_ t, .-,`,K . rar-~,~='` f.r,7 / ;f'",c:J
<br />W ~ r HtER Wt(Y OME C.WSE PFR i!M( FOt (t tD). AHD (a,) -- - ~ N,,,ei bow w~ ~ ~n
<br />-.~-...,~.,a ~..
<br />DUE TO. Oa wa A LONaECYENC[ r>r: "'"J i ~,.,.., ..,,~.. r,..r.....w
<br />E •.,.......~r+.. „r Pnar aa.wnna. ~ lswuN [r w N.t i R}WMN a CCADNE!
<br />= E k'fer Ur Yr y Wl
<br />. -5i1iE$ TIiLS f:OFY CARRIES T'ETE RAISE SEAL OF THE NEBRASKA
<br />STATE"DYXeIitTHENT OF HEAI:TH( IT CERTIFIES THE ABOYE TO BE
<br />A TRO$ CO!"C tIF AN ORIGINAL RECORD ON FILE WITH THE STATE
<br />DEpARTM OF HEALTH. BUREAU Oki VITAL STATISTICS, WHICH
<br />IS '~ DRFOSITORY r^{?R VITAL RECORDS.
<br />(~~
<br />~C~~
<br /><H« &ECR tssuea March 15. i9&k
<br />A53LST1lNT DZItBL"TflR OF EtEAt.TH LTNCOI.N. NEBRASKA
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