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<br />Ronald Lee Badura Male November 3, 2010
<br />A. CIIY AH4 6TA7i oR TBRR1f'PRY, OR FOREIWI COUHTRY OF 91RTH 6a. A(i6�l,�rt �rthdyr 06. UNOlR 1 YlAR 4c. UNGElt 1 GAY !. pA7E OF NRTH @lo.. �rY. Yr.)
<br />(Yrr.) MOl. PAYIi HOURS WPM.
<br />Loup City, Nebraska 82 May 4, 1@4B
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<br />� Omaha 88798 Dou las
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<br />LL Nebraska Wail Grand Island
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<br />� 715 Dean Street 6gSq1 C] r•• �"�
<br />1M. MAIpTAL STA711S AT TIIAE OF DEAtH � M�nisd Q IMver M�rthd 1Pb. NAME DF SNOUBE (FlrsR Wddla I.rsR WfHx) NwRa. l�Iw n+Ydr+ nrn�.
<br />_.._. .� ❑ ""'"''"'. °'n'""""aa C7 ww°,K.° ❑ °"°�." ❑ um�°"" Joanne Laldman
<br />� 71.�FA7F1lR'S-NAME (Fhsf, Mlddle, LuR SuNix) 12 M07HER'8-NAM@ (1'1nIL Mlddle, MNdrn 5um�mr) .
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<br />27. NAME. 7tTL8 ANO ADDRF86 OF C6RTIFIER (PHYSICIAN� PHYSICIAN A891StAMT. CpRONE PH1f81GAN r qR COU 7yp� nr PrIM) � .
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<br />tdr. RlOISTRAR•� BK�NAtI1RE ,,. „ . ,,,�,�. � pu41G F��A 9Y �TRAR (M� �V. � 1
<br />P �-�".�.....�� �,. t, 2010
<br />Thais certifies this documant to be a true copy of an original record on file with Vital Statistics,
<br />Dauglas County Health Dept., Qmaha, Nebraska. Certified copies must have a rais�d seal in the
<br />area to the lefk. Reproduction of this green certificate are nat legal copies.
<br />Date Issued:
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<br />NOV 4 2fi�1D Registraz: C� �.�iC�
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