Laserfiche WebLink
<br />I <br /> <br />DI DIN -H.u., <br /> <br />,.. <br /> <br />STATE OF NEIUSU-OUAITMENT OF HEALTH <br /> <br />CERTiFICATELO,AOE:TH ?l<'L) B4 - -00283(.0 <br /> <br />MIDOlE lA SU 0"''' 0 01"'" ,...... 0.,. Yd <br /> <br />I <br /> <br /> <br />I. Walter Ellis <br /> <br />UCE (e t . Who... ,.... A....IC_ OItGIN/OfSCfN' (e . . hClh... ....ie.It. <br />~..-.." ~tt:' ::-~. .11 I (S".."" <br /> <br />(I ANO A" Of "ItM (II lie' i. u.s..... <br /> <br />I <br /> <br />IUIOIN(I- STAIf <br /> <br />,...Nebraska <br />. HAM <br /> <br />Charles <br /> <br />w. <br /> <br />INSlDI CITY lIMItS <br /> <br />1s.:. Grand Island ~~~s"~' <br />LA MOTHI <br /> <br />Pearce 1 Dottie R. Johnson <br /> <br />IN'OIMAN' - NAME 'fI.ArIONSH'~ - MAiliNG AOOII55 ($'." 01 "'.D. MO.. enl' 01 tOWN;. Sf"". '''1 <br /> <br />..Mar aret Pearce Wife 612 W. 11th St. Grand Islana88Bt <br />"MUI." 01 CIlMAIO.V-NAME LOCAl.ON CITYOI:fOWN $TA" <br /> <br />". <br /> <br />Hall <br /> <br />WAS DECEASED IVE"N u.s. ....D 'OICES? <br />"". "".....'''1'....... .;-_......~..-..I <br />1'_ i.~O <br /> <br />IU".l. Cr....i_, 1-.01 Dol <br /> <br />~, <br /> <br /> <br />Cemeter .... Grand Island Nebraska <br />(sr." 01 -.r.D. NO., (I'" 01 ~ ".". '''' <br /> <br />Ne.6880l <br /> <br />.IJ <br />It <br />!.- <br />Jf <br />..{ <br /> <br />.... <br /> <br />N lMe., 0.,. ',.) <br /> <br />HOUI DU..'" <br /> <br />M <br /> <br />2A. 231 <br />,. ... __.. .,~.. .... _......,.. 1;_. ..... ..... .,1... ... .. .. .. <br />c............. <br /> <br />. <br />NAME AOOUS$ Of <br /> <br />"GIS <br /> <br />2'-.(5;.......,. <br />21. &MMI:DI.n <br />'... <br />:.. coronar~ occlusion <br />DUE TO. 01 AS . C SEQUENCE Of: <br /> <br />lO' <br />DUE ro. 01 AS . CONSlQUENCf Of: <br /> <br />1.1 <br />,.., <br />" <br /> <br />- <br />lMfUh A' ~ <br />I...... 1'. .. Mal <br /> <br />"..'01.......... <br /> <br />CIII.Gl:1QW!IlI <br /> <br />..... <br /> <br />R~99.R ROOIERS MEMO:c ~'r ,a.: <br />'~"--i'''ILL~ <br /> <br />WHEN nm~.~Cct~i~1HE RAISED SEAL OF THE NEBRASKA <br />STATE 1l~'QF~TIl, IT CERTIFIES THE ABOVE TO BE <br />A TRut- P~"oi,':A!r~c:f~G_.RECORD ON FILE WITH THE STATE <br />DEPAR~i:ll;'liWta, BYREAU OF VITAL STATISTICS, WHICH <br />?\'Al' ~SQ:ORY ~R- VITAL RECORDS. <br /> <br />~H':B <br />RICHARD H~',,~t'':'~ : a. Issued Hay 22, 198" <br />ASSISTANT DIRECTOR OF HEALTH LINCOLN. NEBRASKA <br /> <br />R..; 'of Deed$>--' <br /> <br />~ <br /> <br />L <br /> <br />L <br /> <br />-.J <br /> <br />L <br />