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<br />WHEN THIS COPY' CARRIES THE RAISED SEAL OF THE NEBRASKA
<br />STATE DEPART?~fENT OF HEALTH, IT CEATIFZES THE ABOVE TO BE
<br />A TRiiE COPX OF AN ORIGINAL RECOP.D ON FILE WITH THE STATE ~ ~
<br />DEPARTMENT OF HEALT"tl, BtfREAU OF VITAL STATISTICS, kFHICH -~ ~ ~ 4
<br />ZS THE LEGAL DEPOSITORY FOR i'ZTAL RECORDS. ~ ~~ f
<br />DZR£CTOR OF VITAL STA'PISTZCS AND A~SZSI'ANT STATE REGISTRAR `t'°_~• = - ~,.,
<br />LINCOLN, NEBRASKA Ensued OctcS~r 30, Y;"8 -_ " (~.
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