~` STATE OF NElRASIU-DEPAIITMENT Oi HEALTH
<br />8 ~' --U ~J 1 ~ 3 5 CERTIFICATE~DF DEATH ( _~ -
<br />
<br />DE EDEN -NAM 1 MIDOIE ~ Lt-~Tl- E% DA E ~ D ATN (MO., DaT. Yr.)
<br />,_ Warren Frank Kensinger ,Male 1l4arch 4 1981
<br />RACE-,v.q., WhtrE, Rlxk Aanrton QlIGIN(DESCEN7 N.R., Irollen,Mn:een, AGf-tvN E~nMer UNDER 1 TEM UNDER I DAY DATE OE RIEM (Me., OeY•Tr.l
<br />Indian. Mt.1lSpErdY) Gor.on, oK.)(Spvrihl (Yn./ MUS. DAIS NOVRS: MINS.
<br />,. lJhite s- American ' ,e 'j6 bb. « 7. %~I~1 9E 1904
<br />CI AND STATE OF RIRTN( nsE in U.S.A., CITIEEN Of WHRT COUNTRY~MARRIED, NEVER MARRIlD, NAME OFS SF(NrdE. pivE NwidEN AeAN)
<br />n,) 'w1DOwED.OrvORCED (Sp.F.l,l
<br />R~~~Grand Island 23e. ,4. USa (ID 1•Iarried III, Thelma Ruth 13x11
<br />SOCIAL SECVNTY NVMRR VSVAt OCCUPATION (Gi.E S:nd o/t.er, dvw dv.idq ~ttm KIND~RUSIN[SS OR INDUSTR`! CCNINT'Of OFASN
<br />at trerSiny Ylv, evEn i/rorind) ,l _
<br />,7. Q'j-2 -22 5 !>p. •) ~ ' T36- ,b. Hall
<br />CITY, iOWN OR LOCATION OP DEATk INSIDE CITY tIM1T5 NOSPITAt OR OTHER INSTITUTION-NOwo (1/nel.n Nfhor, IF NOSI. OR tN3T.IMI,eN DOA,
<br />ISO«iy TH Or Ne) giro rr.Eerand nulnbEr OvtpvN.tYEavr 4.InpeNEaelSPOrdFt
<br />Idb. Grand Island ,«- Yes Ld.Haumann Dome ,... In tient
<br />
<br />RESIDENCE-STATE COUNTY
<br />dTr. TOWN ORLOCAiION _
<br />STREET AFIDNUMRER INSIDE CIT'UMtTS
<br />fx. Nebraska /sb. Hall I&. Grand Island ISd. rsp.Fr~rrEre;Na
<br />24 tJ. Anna Ils.. Yes
<br />A -NAME MI LE US MOTHER-MAIDEN NAME fIR T MI ~- I~1-'
<br />t+/iiliam Kensi er Abbie 13a,ttles
<br />WAS OKEASED EVER IN U.3. ARMED EORCESY INFORMANT-NAME-REGTIONSNi1-MATTING ADDRESS ,STEER M E.E D- NO.. CITY OE tOVrN, SCAN, ilPl ~:
<br />LY... ,n....nlr j DI ,«. ,... _n, e.d anr« m .......r
<br />IR. Ilo I s.i~trs Thelma Kensi r-l~life- 2d W.Anno.. Grand Island.Ne=
<br />UMAI, GEtnotion: RENOroI DAi CEMETERY OR CRE/MTORT-NAMf LOCATION CI7T OR TOwM STATE
<br />70e. ''1 ~~ IdarE 1 81 7Dc. West awn I•Iemorial Park 70d. Grand Island hE _
<br />EMRA -S ATURE LI SE
<br />248 FUNERAL NOMf -NAME AND ADDRESS (STElEi W • E D w0. CtT OE TOwN. STATE. EIN
<br />: i 77 'vin_aton-'ond r 's U" l:oeni G d Island
<br /> GATE Of (MO.. DaY• Yr.) DATE SIGNED (Me. De>. Yt) (HOUR OE DFATN
<br />t: rch 4, 1981 ~_~: ~
<br />~» 73x. ~:raD I7Aa. j7Ab. A,
<br />
<br />s'i .
<br />DATE SIGNED (MO., bel•Yr.) ~NOUR OF OEATN :iC jPRONOUNCED DEAD PlONOUNCED DEAD(NOUr1
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<br />!d8 ~(/ 7: 3C p.m. iV~t e'(Me.. DeY, r.l
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<br />714 ,3h. M
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<br />ndr. • uY Ylnlen Mat. ~rvnN .+
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<br />~t o r.~_ Mw a.d ela owd d ~ a rl.. urN~.taM.
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<br />73d.1+'E'+'v^ aM t~N.) ~ ~V~i
<br />NAM E ANO ADDRESS Of CElTIFI (PNTSKIAN. CO E!'S PNY31[IAN OE CO tt AYTOlNFYI (r... ., v..,.re
<br />7s David R._Colani4e ;}„ `]2y North Custer ave., Grand Island, Ne. 68801
<br />REGISTRAR , I pA1~ElYED !T gEGISTRAR (Mo.. DoY. Yr.
<br />!~r/!!/~.~1! r? ;111 ~~ ~.
<br />7 lMMEDIAYf CAUSE !ENTER ONLY NE CAUSE PfR LINf f0R (ol. (bl. AND (r11 '~ nt.nvl fv.ww en.,r vM davA
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<br />LoI i LGO s a°it.E.O "C ~ a.G /.~.. a'.E.t vrr` v '.a C/A~T ~ 1 ~ ! U ~C~.
<br />DUE TO. OR AS A tONSEOUENCE Ci: Int,...l bwww ,nw.nd MsM
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<br />DUE TO, OR AS A CONSfGUENCE OF: •tw.e1 bw.v«.nw and drt.
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<br />MRT NITKANr CONpTroNS-CtxKni.n <wN,SN~n, w MM We w.t .NeM F El to rEMtf. wA3 iMER! • a lOI3Y wAS CASE RttlMED tO FNDOU.I
<br />I, vltGwNCT tr rht ryi S MDNirt3t ' fSew.rr rx v. wl i liurr,EE Q COEONlE
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<br />To C~ Ne ~ ; JR C v ~d :7s /S(f
<br />ACUMNt, SUKtOt, NOWCtpl. UNDFT, WtE Of INLYE, (r.. Dar. r. l i ttOUE a ~wuEY •D(KMt .eOw rwUEY OCCYEEtO
<br />W PNNDIn61NVesnD•A(rp{ (3 •hl ~. ~ ,
<br />7Da. Y~.c..v `5 3~. ' IQ- M ~ 1Dd
<br />uRr AF wr1EN n/dE w n+wn- u n.... t«.. » l.r,,,,. - ioe.~ro. i:i!!T oe i i D w cm of row. srATe
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<br />10x. 1DE., ~_
<br />ii~E~1y-°T'3iZS`'E,(~PY CARRIES THE RAISED SEAL OF THE NEBRASKA
<br />5~ZiTE A$~rYFA'$T~'1ENT OF HEALTH, IT CERTIFIES THE ABOVE TO BE
<br />iFBPY3#{~~-. iiN ORIGINAL RECORD ON FILE WITH THE STATE
<br />II -M$NT O~-$~ALTH> BUREAU OF VITAL STATISTICS, WHICH
<br />$~3G,~`•b'r~'OSITORY FOR VITAL RECORDS.
<br />/S°
<br />P~,F,t+~ Y- 1 ~h.L-f~ . i
<br />DIR~`0~ VITAL STATISTICS AND ASSISTANT STATE REGISTRAR
<br />LINCOLN, NEBRASKA ` Issued March 17, 19$1
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