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201�08942
<br />WHEN THIS COPX CARRIES THE RAISED SEAL OF THE NEBRASKA STATE
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A.����� PY,,
<br />OF AN ORIGINAL RECORU ON FILE WYTH THE STATE D�PART�IEI�,Q�? �� 1"TT'I,
<br />BUBEAU OF VITAL STATISTICS, WHICH IS THE L�GAL DE�'��bRY �'Q����,��
<br />VITAL REC017DS. "_ :
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<br />� �� ' ��� u , :¢ � ,
<br />DATE OF ISSUANCE �; ,. .. � '` � `"� _
<br />..�. 1 �.�
<br />(��;� � � STANLEY S. ��4P�R, DZREC�TQkaJ'
<br />LZNCOLN, NEBRASKA BUREAU OF VZTA�.,�'S��T�S�'I�S�
<br />• ;
<br />STATE OF NEBRASKA—DEPARTMENT OF HEALTM
<br />9UREAU OF VITAL STATISTICS
<br />CERTIFICATE 0� DEATH _ 5 � . �
<br />DECEOENT�-NAME FIRS MI l lA SEX A E OF DEAiN (Mo., por, Yr.)
<br />�. Eleanor Ann Jones = .Female Se tember 2 1988 --
<br />J RA6E—Ir.r; WM1nr.-�1act; Ar�rken C#IOtN]p[�CENTj�.q., holian. M���een, A!-4ap N�Md.y UNDER 1 YEAR UNDER 1 DAt DATE OF lIRTM (Me„ per, 1'r.)
<br />Ind�a�, �1c.) (Sp�ri/r) C»rnwn, dc.1(Sp�ti/r) (Yr�.J A/O5. � DAYS MOURS . MINS.
<br />.. White ,. American e�,. 5� be. � �. � �. October 7 193'1
<br />CITY ANb STATE OF �01RTH (K ne1 in U.S.A., CITI2EN OF WNAT UNTR1' MA IED. NEVER AAARRIED, NAME Qf SIONSE (Nwih, piw iwerd�n na��)
<br />naw.� rounhy) WIDpWED. DIVORCED(Sp�ci/r)
<br />�._Spalding, Nebraska o, U.S.A. �o. Married ��. Ron Jones
<br />SpCIAI SECURIiY NUMSER USUAL OCCUMTIpN (Giw kind a/ worM don� dnrinp met/ KIHD Of 6USINES$ OR INpUSTRY COUNTY OF pEATH
<br />e/re.kin lii�. �wn i/nHnd)
<br />�z. 505-46-1267 , a ,. �Iomemaker ,36. Own Home ,.a. Hall
<br />_ CITY, TOWN OR IQCATION pi pEATFI INSIpE CI�Y IIMITS HQ5►ITAI OR OTMER INST�TUTION — No� /I/ npl in �ilh�r, li MOSI. bR �NST. Indisee. DO�.
<br />(Sp�ci/r Y�t e. NeJ piw tMN and num6�r) �����^Nlwr.. R� , Inpari.nr fSv«%hl
<br />„ Grand Tsland „�.Yes �.d.At Home-22Q4 W. Division u.. NA
<br />RESIDENCE—STATE COUNTI' [ITY, TOWN OR LOCATION STREET ANC NUM�ER INSIDE CITY IIMITi
<br />(Sp�ci/�r Yrt w No)
<br />�se. Nebraska �sb_ Ha11 ,x. Grand Island �sd. 2204 W. Division ,s., yes
<br />FATHER—NAME FIRST ��� ������ � ���� � MIDDLE lA MOTME�—MAID N NAME FIR T MI Dl LA
<br />, Patrick NMN McManaman Lillian NMN Lawless
<br />WAS DEC�ASED EVE� IN U.S. ARMED FORCE57 INFORAAANT—NAME—RE1A110NSHIP—MAIIING ADORESS (StiEEt pir R.f D. HO., C�iY OII tpwN )
<br />(r�. ��. w �..wl U� w�. 9+•• r'ar end delw o1 ywi<�) ��
<br />,a. No I -�------ i9.Ron Jones Husb 2204 W. Division Grand Island Ne.
<br />AURIAI, Cr�matioe, Rane.�al PAT CEMETERY OR CREMATORr —NAME tOCAT10N CITY OR TOWN STATE
<br />�. Burial zoe�e t. 6, 19$8 zo�.Westlawn Memorial Park aod.Grand Island Nebraska
<br />EMpAtM R-5 A1URE UCENSE NO. FUNERAI MbME —NAME ANp ADDRfS5 �STRElT o11 R.f.D. NO., [�T'Y 011 T4wN, STwTl, tl►1 b8HO 1
<br />:i. z�,ivin ston-Sandermann 505 West Koeni Grand Island, Ne .
<br />DATE Of DEAT ., Dar, Yr.) DATE IGNED (Mo. vr, Yr.) MpUR OF bEATH
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<br />��_ DATE 51GNED (Me., Der, 1'r.) H UR DEATM o -� �`i T pRpNOUNCED pEAD PRONOUNCED DEAD(Hovr)
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<br />_� NAM AND AODR S dF CE�TIFIE� (PHY 1 IAN, CQRONER' ►M SICIAN OR COUNTI� ATTORNEY) (��or pri��l)
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<br />REGISTRAR DATE RECEIVED 6Y REGIS R(Mo., Doy, Yr.)
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