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<br />STATE OfHEBIlASKA-OE'ARTMEIIT Of HEALTH
<br />BU~REAU Of VITAL STATISTICS
<br />CERTJfICATEOf'DEATH (
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<br />83-005932.
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<br />DECEDENT _ NA.ME
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<br />FltST
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<br />MIDOl!
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<br />Joseph L.
<br />IAC!-{e g. Whn. Blodi, A._,ita" OIIGINtOfSCfNT(e g, IfOhOI'l,M..lI::(ift. AGE h.ot .."Mlo"
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<br />I'NfOllMAHT _ NA.ME
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<br />i..Tom ru:o* neohe\v
<br />ICEMnEt.,. 01 CREMATeS Y-NAME
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<br />8~t, Patricks
<br />i fUNfUl HOME - NAME A./'oJO AODRESS
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<br />Dowd
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<br />704 E 4th Me Cook, Nb69001
<br />!lOCATlON CITY Ofl: TOWN- STAn
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<br />110<1 Adams Co Nebr
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<br />WHt!i:c~~til~?~c)1.~'\CA.e.RlES THE RAISED SEAL OF THE NEBRASKA
<br />S'fA:~lD-eV"*,"'~IF" OF HEALTH, IT CERTIFIES THE ABOVE TO BE
<br />A::T"M~.:..COpyot :A1Hi9,RIGINAL RECORD ON FILE WITH THE STATE
<br />D'~AA~~ENT OF HI!~TH, BUREAU OF VITAL STATISTICS, WHICH
<br />ISi,~:I,.EGAL O'Q?5ITORY FOR VITAL RECORDS.
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