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<br />COPY CARRIES THE RAISED SEAL OF THE NEBRASKA
<br />i-.,VENT OF HEALTH, IT CERTIFIES THE ABOVE TO BE
<br />~':~~+ AN ORIGINAL RECORD ON FILE WITH THE STATE
<br />~.OFSHEALTH, BUREAU OF VITAL STATISTICS, WHICH
<br />~;jz-IYEPOSITORY FOR VITAL RECORDS.
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<br />ND ASSISTANT STATE REGI
<br />Issued October 28, 198'2
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