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<br />STATE Oi NEfItA3tUt-DE-ARTIREIIT OF NEIiLTN
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<br />EUREAU Oi YtTAi STATISTICS
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<br />~E OF DEA4H -
<br />CER'tiFiCA
<br />-NAM FI~-~~ MfbOIE .-.-.-_IAST _____ S~-____ UA~t ~ DEATM IMO.-Our. Yr.1
<br />male 1, November 6, 1979
<br />Glen Alian Sip dle
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<br />- -µCE _(A.y., WMlti, lNcM, :Minykaw gIGM/OESCElET b.q.. ~Si~.. M^dron. AOE-+au f+MM UNDFt i TFAEr UNDER 7 DAY DwT[OE EIETM (Ma., DaY, Y..)
<br />)tea, ,sr,yTSp[r:Y,y Q11ppx. Hr.)ISpN:1Y) (Yn.} MOS. ~ OAYS HOURS• MINT
<br />~ -Hpril 28, 1919
<br />60 ,,
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<br />unkrawn '»
<br />whzte
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<br />by
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<br />• A OF tWttN {q Res in U.S.A.. CITS tli WNAiCWNTM MwH1FD, N[NER MARRIED. NAME OF SVOUSEl1/ri/e, yiw nrnid,n np«e)
<br />DIVORCED (SANI/Yl
<br />Mr1Ot1WED
<br />.
<br />tpwr 7
<br />Emma E. Miller
<br />married „
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<br />braska-
<br />shu ~er
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<br />. ,D. .
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<br />,
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<br />(G., Eiwdafwhdarv during wev RsND Of IUSINESS OR INDUSTEY COUNFY Of DEATN
<br />SECftRFTY NUMDER UEISAt OC UEAitON
<br />~y
<br />316 ~ '~n~t,EOd a~'i R14~tE~ae~ing Hall
<br />) }p, ! b.
<br />,507-10-9
<br />CITT,TOWN LOCAl10N Of pFATN INSIDE CTTR l1MIT1 NOSMAt OR OTNERTNSTfTUT10N-Npr (Il nnl in either, NNOA. 4f torsi. t.dk«»DOA,
<br />OrMrb«/tnxr. 4.Inpaxam (fp«Ay)
<br />tSp,triYT NNA/ g«, Nn«n nbN/
<br />Grand Island ,k. yes ,.~. ~~ Hos ital ,,,, inpatient
<br />- Relt7FEKE-STATE COUNTY CITY, TOWW OE /OCAiION STEEET AND HUMlER INSIDE dTTIWITS
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<br />~„<. Grand Island
<br />.r_ Nebraska ,sb Hali rap.6+rYe,NNe)
<br />,w 617 South Locust ~,,,. yes
<br />tRti= N u~-T
<br />dec. Charies Spidle__1
<br />A3 OK(+f,SlD HrlE IN U.S- ARM[D FOECEST i 1NipRMANT - NAME - REtAilpl
<br />!ltx y,a
<br />'s%WK#I/1b-31-diJ10-18-d sEmma Spidle,wif
<br />,St, cr,.,«yn,RNaRrni~ CEMETIFRT OR CRtMATWY_N~
<br />.ta.[ l -8-1979~2~t~fcwm C¢me.
<br />NO iUNERw3 MOMF-NAME AND 4
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<br />i T. r -Y a,n.I « w. x... ew..rt~ w«...w ra r. x.. _
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<br />-MwIDEN NAME HRST M: -~~T
<br />dec.) Cora Gambrecht
<br />MAHING ADDRESS IST3E[T De ^ f.0 NO.. [iiY Of TOwN. SiATl. Tt»1
<br />7 S. Locust Grand Island, NE 68801
<br />-- ~ souTroN clTr oR TowN STATE
<br />;,Dd Gxattd ie~artd, Nebxaeka
<br />csretr oe : y a N4 un a TawN. STatt. nts e s gQ 1
<br />I Fun¢~tal Home 1123 w. 2nd Gaaxd Teeand,
<br />/ JJ : d. h awn M ~.arw« W/r iw++/.ri~.. ' -y Miww~ dwT «rvrrM er - - _
<br />Y • Tr.) -TM~1 t q OEA~M ~ : i < < A oY. Y») ^ N
<br />~!S ns November I3, 1979I,k 6:lSa. ~~?'jTa6 s« M
<br />l~ iDAif d DEATH tMe-, Dp, rr./ Eoo ~IRONOVNCED DEAD .RONOUNCED DEAD MnnN
<br />"O. ?fun .Day. Y~.3
<br />~ November 6 1979 ~ 's+d ~.. M
<br />MAME AND 5 ERTS/ER IEiiYSiCUM, CORONER'S YNYSiCIAN O0. COUNTI ATTORNEY) (Type « Ennr)
<br />~nrioueta A Bellosillo M.D_ VA Hospital.<201 NorthBroadwell Grand Island.NE 68801
<br />n DAT; RECEIVED RY tEG6TGR (MO., Oaf. yr.1
<br />
<br />. Mt33ED1At! k LATER QIttT ONF CAUSE EFR UNE fOR (el. (b). AND (~I! .a..« b«new xwrr» «.d
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<br />„'Carcinoma of the lung with ~)etastases to bones mons
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<br />O. AS A WSSD]UENC[ Oi:
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<br />DUE i0, OR AS w [OMS[4s)[NCE Oi: "^°' f""" e"er °d d'e1f
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<br />at.Ctq . SUIC1nt. MOwL1Ot. YlrMl., t W[ 0) 1MlLfy lww. D9. [• Y I NOYt 4t WY[y
<br />p Eit3Rlrtq eNg3ltpALON. (3,«AN 1
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<br />NOM ~llA~"~t jw)yh- u a»se, 1»~wnµ ,may. . LOC ya~f W[ C!T O! tOwN SIATt
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<br />,NiY YrK.a,. w'tSN»dyt
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<br />it'd&IS C4~E~'CARRIES TdE- RAISED SEAL OF THE NEBRASKA
<br />,$Tl~'TE DEPA$T!lL~~_ OF REALTH, IT CERTIFIES TAE ABOVE TO BE
<br />A`~.`~{tEiE COPY°_0~~,~1N ORIGINAL RECORD ON FILE WITH THE STATE
<br />D,H,~ $T,II~IT-QF''ALTH, BUREAU OF VITAL STATISTICS, WHICH
<br />ZS~ ~3~ H~POSITORY FOyR VITAL REC.}OR/DS.
<br />~ d /ll~ ..rblltsa.~l
<br />DIkEC1Y?$?,UF`VITAL STATISTICS AND r,SSISTANT STATE REGISTRAR
<br />LINCOLN, NBBRASKA _ Issued wovember 27, 1979
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