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<br />I <br /> <br />83-')05382 <br /> <br />STATE OF IIEIIlASllA-DE'AIlTMEIIT Of MEAL'" <br />IUIEAU OF VITAl. STAnSTICS <br />CERTIFICATE OF DEATH <br /> <br />83 08292 <br /> <br />" <br /> <br /> <br />-, <br /> <br />_N <br /> <br />I <br />RfSlDfNCf <br /> <br />,... <br />A <br /> <br />."". <br />t..........,. <br />--.pI........ <br />3d.f~....r;..,. <br />, NAME AND ADDUS5 CmWIEI ( <br /> <br />z'~ OAT 10 tM$. 00,. Yr.' <br />~:!I 24a. <br />tis .. 'IlONOUNC'D DEAD <br />....e: "i (Mo., OQ,. Yr.' <br />u!:;z ok. <br />.J 15 0.. .... ......., ._......... aood'" ............ j.. ..., .p...... ""-... M(Vn'H ..t <br />,!:~~ tM....,..........'--......_..~~.......... <br />u 24e. 11>._... .._"".,''' <br />Irs 'Ml'51ClAN 01 COUNTY ATTOINEY) {Type 0' ',ittfJ <br /> <br />..... <br />PaONOUNCED DEAD (Hov" <br /> <br />.. <br /> <br />David R. Colan, MD. 729 N. Custer Grand Island Ne <br /> <br />::'~=NI~ ~/ < c;;" (~,ii~ (r' i"c"J' <br />. IMMfOIATI uS! (INTE. ONlY ONE CA.USf ,,. UNE FOI (oj. (b/. AHD tel) <br />'If' ' <br />'01 DUI TO.~~CiIrc.uI..{?c;.YOCh.tA u4-L I/f/'?M.c. 770AJ <br /> <br />.. ,4'1H'J~o!.cLU.c77c. HULf ~/SCASI <br />OUI TO. OR AS A CQNSlQUfNCt: Of: <br /> <br /> <br />, ..........b__.owt..... <br />; .$",PA)If <br />, I........ "...... ...... ..... .... <br /> <br />I r' 'dA6 <br />, t...,..,..&...-........ 0.... ... <br /> <br />~l <br />,- <br />H J1y, <br /> <br /> <br />STAn <br /> <br />4D/:s <.._(<;) Q~d Nve(S) in B/4cl.( G MacGi!/ <br />.' ..r, ,.' '. :;:" ,.... . ..".i .(.+?tI'Cf,I-T S:9<-'~J Ai/;-!,o,? I to.,J eJIP:, dr(1 <br />,',.' "., e,,,...iy I /Ii.JI>rUl(q <br />WHI8........".. :'rfJ.. vs...CO.Py....~.'.R....~IES THE RAI SED SEAL OF THE NEBRASKA STATE <br />OE~~Tt1Ettl,.O.F tl~teT.J:I, IT CERTIFIES THE ABOVE TO BE A TRUE COPY <br />OF".~.~IG;IM~t~WRD ON FILE WI TH THE STATE DEPARTMENT OF HEALTH, <br />BUR~~I{bfVll~S~TISTICS, WHICH IS'THE LEGAL DEPOSITORY FOR <br />VIl: '" ~ OM~,. .. <br />./;t~ <br /> <br />ASSISTAN D REC 0 OF <br /> <br /> <br />Issued September ]0, 198] <br />liNCOLN, NEBRASKA <br /> <br /> <br />~ <br /> <br />L <br /> <br />L <br /> <br />-1 <br /> <br />L <br />