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<br />STATE Of "f.RASKA-Ofr..lIUNT Of HEAlrH
<br />BURfAU OF VITAL STATISTICS
<br />CERTIFICATE OF DEATH
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<br />84 - 002989
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<br />WHEN THIS COpy CARRI~S ~Hf RAISED SEAL Uf THE NEBRASKA
<br />STATE DEPARlMENT OF HEALIH, '.ERTIFIES THE ABOVE TO BE
<br />A TRUE COPY OF AN ORIGINAL RECORD ON FILE WITH ThE STATE
<br />DEPARTMENT OF HEALTH, BUREAU uf VITAL STATISTICS, WHICH
<br />IS THE LEGAL DEPOSITORY FOR VITAL RECORDS.
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<br />.________~ ~ .d .- ..11:. ~ '",
<br />DIRJ.:CYOR OF VITAL STATISTICS AI;!) ASSISTANT STATE REGISTRAR
<br />LINCOL~. ~iEBRASKA I 'isu~d ;,-tar(:h :':5. 1982
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