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<br /> LOT 7, BLOCK 34, ORIGINAL TOWN OF GRAND ISLAND, HALL COUNTY, NEBRASKA.
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<br /> STATE OF NEBRASKA
<br /> WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTMENT'•O~ rALfiH iA(VQ
<br /> HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE<RI~iFI~AL RE-C69D ON, r 5
<br /> FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICE~'~VITJLrl gowns' ;
<br /> OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS.
<br /> DATE OF ISSUANCE
<br /> FEB 2 4 2010 201001446 STs"LEA QE ;
<br /> ASSI~TAIV rA'T!~ ~E~,ISlRAR'„' ;
<br /> D,5kART;N'T OF HEALTI•{ANd
<br /> LINCOLN, NEBRASKA MlIt1~1N RVSGE$_
<br /> STATE 'OF N14A UPwrolm,OF HEALTH'
<br /> Boman Tltild SEIIl1.Eia1
<br /> CERTIFICATE OF', MEATH,
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<br /> I-Ott LAST UX 'DATE CO OfASN ME
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