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STATE O�' NEBRASKA
<br />WHEN THIS COPY CARRIES THE RAISED SEAL O�' THE NEBRASKA DEPARTMENT pF HEALTM.ANb�K(JM�N SERVICES, IT CER77FIES
<br />THE BELOW TO BE A TRUE COPY OF THE ORIGINAL REC(7RD pN FTLE WITM TWE NEBRASK,4,�P � Tltil�l�T�QF WEALTH ANp
<br />HUMAN SERVICE$, VITAL R�'CORDS OFFICE, WHICM IS THE LEGAL PEPOSITORY FOl2 VI�/�L + +;
<br />DATE OF ISSUANCE
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<br />54 Dctober 15, 1951
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