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<br />r <br /> <br />-, <br /> <br />.- <br /> <br /> <br />STAll Of Nllll.SU-DlP..,.MEIIT Df HLUTH <br />IUlllAU Of VITAl STATISTICS <br />CERTIFICATE OF DEATH, <br /> <br />83-005246 <br /> <br />.., <br /> <br />$rAJi! <br /> <br />Island, 1'Ie. <br /> <br />24b. M <br />PRONOUNCED DEAD (Holl,J <br /> <br />.... <br /> <br />:,' ';tV <br />. ta..",.t".__ ......... <br /> <br />'0 <br />,- <br />. <br /> <br />w....s CAU lIUIUO 10 "'DI'''' <br />UIAMINt* 01 cOtOMla <br />:;-c,Jp IN .. He, J0 (.) <br /> <br />st..IIOtu,D...... <br /> <br />CII't' 01 10.... StAll <br /> <br />............"., <br />::; GF ,',', <br />WHEN T~;,~.:CtiPY..:tA~IES THE RAISEO SEAL OF THE NEBRASKA STATE <br />DEPAj\TKEH1 OF HEAL11i.' H CERT I F I ES THE ABOVE TO BE A TRUE COPY <br />OF AW.OIUGI.NAl RI1CQRP,;9N FilE WITH THE STATE DEPARTMENT OF HEALTH, <br />8Ul\E~Of! VIT~)irAT~,S,TICS, WHICH IS 'THE LEGAL DEPOSITORY FOR <br />VlT RDS,,' ,:," <br /> <br />,:;::,.,,~~ " <br /> <br />R'OF E LTH <br /> <br /> <br />Issued September'Z9, 1983 <br />LINCOLN, NEBRASKA <br /> <br />