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<br />A YAUE COPY OY AR ORIGINAL REGORD ON FILE IdZT~ TeS 55A3'E
<br />ifEPAHTMELiY Og $EAL?H, BUHEAQ OP VITAL STATISTECS, itHIGR
<br />I"4r T8E LEGAL DEPOSITORY FOR VITAL RECORDS.
<br />DZHHGTOH OFr VITAL STATISTICS AND ASSYSTAMI STATE RFJGIST'SPAR
<br />LI3I~OLR, NEBYASEA ,~ Issued !~Wrc--~i~~1; 181
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