Laserfiche WebLink
<br />STATE OF NEBRASKA <br /> <br />WHEN THIS COpy CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTf;1ENrbPHBAl,.fH AND <br />HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COpy OF TffE,(>f.'1l;lNAf.f1.EptJRp ON <br />FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERV~Ci.~;.V!'rt'f=:R~~p'S, <br />OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS....,' '~J> - , '\ 1\ t " (I,:' I~~"., <br /> <br />DATE OF ISSUANCE : .:: .lJ . ~ <br />, .": $TA '. DOPER : '~ .~ <br />MAY 0 7 2009 20 0 90 3 6 6 7 ~~:. AS~ "ANTisrATJi p.EGJ5fRAR <br />(--/JEPARTMENTOF HEA..'l,./fH 4ND <br />LINCOLN, NEBRASKA '(ftJ:~~~~~. g~R,V~C(~.... ~.:J, ' <br />,~ :c '\:') .t.'. . ...."1 ~~.! :~..~'., ~ <,'\ .... <br /> <br />, ........ INI_ _..... ..... <br />, <br />: 36 Iburs <br />! ............. - .... ..... <br />, <br />4101 PnelUl'Onia. Had fibrosis of the lunt's which lAonlr1 ~. ~t"'t"'lrldaryj 1 M:>nth <br />OUt to, 01 AS A COHIfQUII'tCI Of'r cd iation therapy due to consequen~ of breas t : ........ ~ -..... ....... <br />k) cancer '9 l\bnths <br />,,-,~ I:chemi~c COHDnIONIheart d(~se s..........e '.........., - =U~~~r=.A., ~=~ IlltIItCAl <br />... a · r.. 0 '5L StNoo/fr .'. .. Nf) <br />..... tJ 29. <br />1lICOIIINr. 1UIClIlI, MOMICIOI. UNDIT.. 1M" Of INJUIY (_. hr, '1,,/ DlKlIH NOW INJUIY <br />011 ........ II'ftDlIGtonoN. f~ifrl <br /> <br /> <br />STA". ..n UU-WMTMINT OF MlALTM <br />...... . VITa ITATlITICI <br />CERTIFICATE OF DEATH ('\, <br />- <br /> <br />l ~ I I ',,'; 'j. <br />I... \,' I.. ': \,~ <br /> <br />'85 03503 <br /> <br />. Y...) <br /> <br />1985 <br /> <br />,. . --.-;..... ...~...- <br />IUIINlII OIINOUSTlrY COUNTY Of DeATH <br />Hall <br /> <br />,... Grand Island <br />IIUOfMCI-STATI COUHfY <br />t~ebraska Hall <br />'AntIII~ <br />~._ LaVerne (unk) <br />- WAS DICfAIID mtllN u.s. AIlMID POlen' <br />~:-,po ....1'....' INt -..... - ..__I <br />luIlAl. c.........., ---...1 <br />... Burial_. <br />aU( <br /> <br />M <br /> <br />Island ,NE <br /> <br />68801 <br /> <br />Me., 0.,. ...J <br /> <br />~ 9 ~dcr <br /> <br /> <br />3001. <br /> <br />sTlln 011 ....D. ...... <br /> <br />(1fT 01 WOWN STA" <br />