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<br />STATE OF NEBRASKA � "`" -�
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<br />WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRASKA DEPARTMENT QF IJEALTI,�.A{UT� <, +;,.� "� �
<br />HUMAN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORIGINAL �EC, � Q�1 : d `� ��
<br />FILE WITH THE NEBR.4SKA DEPARTMENT OF HEAI.TH AND HUMAN SERVICES, VITA�,R��b�DS. ....,°. �;,
<br />OFFICE, WHICH IS THE LEGAL DFPOSIi'ORY FOR VITAL RECQRDS. �•' ,< < •' '' "�' � k -
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<br />DATE OF ISSUANCE `` d�.��_ . A ,.
<br />�IAY l 12011 t � QA sTAi��� . ��,���P�� x � � � � r� ; � ; :�� ..
<br />�G"i O � � Q � v `t � AS�ISTAI�If:6TAT�.�d�S�'�4� ' � ' •,;
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<br />Carleton. Nebraska
<br />SYATE OF NEBRASKA = DEPARTMENT OF HEALTH
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<br />CERTIFICA7E OF DEA7'1� t,,, �;,.�:.
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<br />Kathryn Langenheder E`emale
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<br />�epte�nber 26, 1990 �
<br />ur� oF e�arH nw�m�. am rsary d
<br />II�ecember 12: 1895 � �
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<br />o St. Francis Medical Center Grand Island �S�es
<br />U 86 AEStDENCE - STATE 9D. COUNTY
<br />p� N�brask� Hall
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