. . 7 9'.' -f�hp�Y: t '�m�s�i ...��; k�t �-a:���+x�^��ixvu-1.����r���.a�,;�-r�.. �r-t4� t_ ..._. ,�r. yA. _. .. `_" ��--�...�-..'-'ts.�'�C� r _-_."_
<br /> 9�:3�.a���P'Y�� 4 `� r `��� ..o�'•., tl �L —
<br /> �i �-r„_
<br /> �.�.�.......
<br /> ;/ �ra.'•' �/ _ . . .A�j, e:,,o•i"� ..- ''....,���.
<br /> !" q .
<br /> . . ., .•yn......r.art . . .
<br /> �' ......_..�....a.'�... . `.�.�-,. _..� --` -
<br /> .�:..:r.
<br /> • _ —' � .. .... . . "
<br /> . c�! ' ' v" J i :'.�-/Hwlk��. .... __- _ "_ - .
<br /> 'k ��.Ty. � . .. . •.. . h_.:,�i7 . . . —
<br /> .. -...e..,a�. �..µ:�.. ,: .�:.d�•n=ti•�a.o'fS�+C'�c.+s"�c!7�Rc'..o'....
<br /> • YrY:�.:a.�� i'� --•'Si,i�.:r. .....�...aa.:.'�s�s,.LY.'.�"I��„j� �.�_«.-aL _ . -�.ms��.__-�.a-_
<br /> ' � . s=_1�aL��le�14�� - ' --- —
<br /> � :1,. -
<br /> ' '" -
<br /> ,. •• .� --
<br /> ,. ' �: • ` .r•;,s�„A
<br /> +E., .� . -.,�:� - WHSN THIS COPY CARRIES THE RAISED SPAL OI� THE NEBRAST�A STATB --_-----
<br /> �'��'^�� � DEPARTMENT OF HEALTtI. IT CERTIFIES THE HBLOW TO BE A RTRU� COPY
<br /> ti , ' � �' � ' OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEPARTMENT O� HEALTH _
<br /> ' ^� BUREAU OF VITAL STATISTICS. WHICH IS THS LP.(iAl. DEPOSITOAY FOR �,�,,,,,,�.. ___
<br /> . a �ti�r�iF�.r.,;;xt�» ViTAL BECORDB. 9�� �a�t�/?r� �� , �.••^
<br /> ; • �►.:_....�..�. _ � r -_. T
<br /> ' :,, ` . ,�I �../�� �- - �.,..,,�-_r__
<br /> , ' .. ... DATE OP ISSUANCB �����II� � � --
<br /> - � . .lili 1l; i99� STANLEY� s coor.�R► ni�c�ro� _
<br /> ,-� , . —
<br /> -'-. '� "� LINGOLN, NEBxASKA r BURPAU F VITAL 5TATISTICS
<br /> = �=�� .. � �' . "'�� . � � i � ��G �f=!'� ��/ � �' o.r�s.��.sx.�ew,r �. �-
<br />_�;��: .. . ;.. , s� �„�/o�r �� /r�tid�o,��,�'R•-s
<br /> = - a ��.P���;�:vr�� �_ -
<br /> :'��y. ., _' /;p�.
<br />,�r{ fTATt Oi NElIIASIG-OEIARTIIENT OP NLALiN
<br /> f.�` � '!� OUREAU 01 YfTAI iTATISTICB �8 p 3 3 6 7 �
<br /> � . CERTIFICATE OF DEATH�,�� �
<br />�--!•'.'� � � ' T M11 E DA t 0lAT (AN..Oq.►r.) r.w.�u--
<br /> _ " OK! NT- ,_-
<br />.�.;.• ��G. .' � .
<br /> � . � p�,,,�
<br /> ,.d.. . _.. . _ _.._ ._.�_-__._.
<br /> .. . .. RAC!-�.�..WIiIN.• AwMl�r Otl61N10liClNi1�.�.,IN1N�./M�ftM. A6!-� � U UND t (Mi �IUMIAM..M�.h./ � - ..
<br /> , �„��,,.����y oa.....K.1(:r«rh� . r 1rn.� Mos. � rs �wu�s. wNS. .
<br /> ' ° � te e• � °` � --= -
<br /> �ra �nasun�� .ni.u.�.�., emsu+aw�u►ieouNTa ��oowioonro�EOtsw:ap►wuuo�uouserN.� .on...ia��...►
<br /> „ MM i�MM�I �
<br /> ' ,. . � . ��. �..,..V-,'.._�:
<br /> � �,�: - iOtWiECUq1YMYMM� YfUMOCCU�AiIONfOI.�i(./d..ri�/wipwwr It1MDW�UfINtifO�INW�T� COUN1tq0lATN � �.ii�,�.`_--_ __
<br /> ., . .. d wrUwp NA.w��H eNMdl j� ` �^�,-
<br /> � 17. � 1 . I�b. I�a. �---_. _•.--�
<br /> ' pp�/�p� INNOlCIIYtIMITi MOS/ITA101OMl�INf11TYT10N-PMrfM�M1��MMb MMOtI.WIM�f.WkM�f� +',-a.:w..
<br /> � . � fIM��PrHwl�hl yMtMMu/MwMrl OM►MM+1Mw.�a.MwN�wff�w+b1 .;'rM�-'- _
<br /> I�k. N. +,
<br /> �!lIDINCf-iTAi1 CGUNI► Cflr.TOWNORIOCA fTlIiTANGNUW[Il IHSIOlCITtW�1ri '
<br /> . (tr«tl�Y«�rNd ,,ly-�,�e• �
<br /> .. 1l�. 1 If�. 1!/. 1M. ���'
<br /> ' AY ��`�Si�,�871l��
<br /> — -..-- ---_ +�,rtlli'S�ti _` � �°:�!,;,-.: •:�c�
<br /> ,. WAS OEClAf[DlYE�IN U.f.A�MED fqCEff IN�O�MI�NT-NAMt-�tUf10NfH1/-MAHIN6 AOWEf3 1�TYIf O�LI.D�Iq.CT0�10wN,f�Iil.11q ��
<br /> .. " pw.u.«.Aw.wl IM�w���w.r��Mn M w..k�l oOa�Jl � `:k-c
<br /> . . �`f....C.. �.. ~.��
<br /> T
<br /> I
<br /> 1�. 19. . ^",�, �.1. �• av.r.=9
<br /> `x�. . . �U�AI.C/tMAT10N.RlMOYAI OAT! C E T - l T Ir OW iT E '� , � ^
<br /> .. � p,. BurJ.al „�.3/7/?8 �.Weetlawn Memorial Park ,,,. Grar�d Ieland 1� " *
<br /> �-S16NA �t a 11[[Nf!N0. fUMERAI NOMf-NAM[AND AO Etf Ift�!!f M LI D IID-.CIII W iGMN,ilAlt,a� � . ^.
<br /> .� ,Livingaton-8ondexa�nn's�505 W.Koenig� (iraud Is1and�Ne./ . ,
<br /> . :�,.� � � � l , . .. .. , ' �
<br /> � t�M�Yq d q���/�. �a �M ww. •�.r In���M O��M►w��1�p�W tlr�M/r I�wnk�N�"•���!N�N.M�M Mnw��1 F
<br /> � , tM�UI M� N�xr.MM����Ir����M M a�WJ MMM ! , . .. �
<br /> � . .� , 40e.lti �wd NMN� �O►DEAiM �� r � 9/e.f fy.MVn�./hMH�, 7
<br /> I' � A fO fAM..Oq.Yi.) H <w - . --_ --
<br /> .� r� y�t
<br /> `� � S7b. 3�!�� Zk.11{�5 a�10• M ��; 71b. 11s. M _ ��.
<br /> � - �� �OIWYNClODlADfAM�.Oq.Yr.) ��ONOUNC[ODlAOfM�nl j /�OMOUNCEDDEAO ��ONWNCI00lAO(M�n) ..
<br /> d nw..w�.r�.� ,`�..�..:
<br /> / � � . 3-5-7$ �� 11�55 a.m. �' , _-
<br /> I AND ADMlfL OF C!llfl�PNYfIC1A ,CO�OiI!►f�NtfIC1AN OR COUNT1f ARO�NEq f i�p��r InM) � _ �
<br /> 1 .
<br /> ', , �gichard F. DeMqy, M. D.� ,21 Weat 7th 8t•� Grar�d Ieland, Ne• , � �
<br /> � •• �EafTw DATE�fCE1Vl0�Y�[613iG (��j.1'a)
<br /> sa�.�tu.a�.�.�► �' �sb ��/`Q�� ��- -�.-r-/-! �" • -- -- —
<br /> 7. IfIM[01ATE CAUSR ftN � N H!CAU! f N iOR ab!6),ANO fsl) ' �' �M"�r wr���� f � -°-`-=°
<br />
|