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<br />WHEN THIS COPY CARRIES THE RAISED SEAI. OF THE NEBRASKA DEPAR.TM��T Q9�' l-�FA�7�MwAND
<br />HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE� COPY OF..TI=I� GIA/AL.RECORD;,QN
<br />FILE WIThI THE NEBR.4SKA DEPARTMENT OF HEALThI AND HUMAN 5�74 V�f.� '�/�((�R F@DS �,
<br />OFFICE, WHICH IS THE LEGAL DEPOSITORY FOR VITAL RECORDS. � •� `�� �'•
<br />DATE OF ISSUANCE : �' ,
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