.: �� �u. .. _ .� ��t���.�-:+T � �tT' • .. •• . _ �...... - _ .. .�,`� -_. . 4. . __-_
<br /> N_ .�c�
<br /> . "� �1y�"T '.:+...:; ,,� -
<br /> i0i-�i+�..�+��. . � �•?�n.;u�+�«.� s.° ` . ' ,.
<br /> � �. . .-^ , , :, '�;
<br /> � �..a�ei.*-.w„ .. :
<br /> - � . . 's:k.:Y.,-:..•. • ' �4�N„�`f µ y�.cwr•• . . . ,:....l.� �-„---°---_='—_,�-..`'_-- -
<br /> «�: +rl� �.:.�ty.:, --�._...
<br /> . � � . � . _ 92_�0�9 _ �- .��..---
<br /> WN@1 TNiS COPY CARRIES THB RALSED SEAL OP THB NEBWA3RA STATF.
<br /> `�n �`��;•p DEPARTMENT OF HEALTH, IT C�RTIFIES THB BGLOW TU BE A TRUE COPY __.
<br /> ,� " '� i �� OF AN ORIGINAL RECA[tD ON FILE WITH THB STATE DBPARTMI:NT OF HFALTN __
<br /> HUREAU OF VITAL STATISTICS. WNICH IS THE LFAAL DF.8�8ITQAX FOR
<br /> � ^ ., " .•.. VYTAL [t6CORD9.
<br /> � �
<br /> .... , � , --- - ----
<br /> . _ „-_ .. ,(��.,"/ -
<br /> . � .. DATE OF ISSUANCS ������, Q� _ - _-
<br /> ' AUG � � STANLEY S. COOPER, DIRECTOR ��"-
<br /> � .. ��_.
<br />- LINCOLN� NEBRASKA BUHEAU OF YITAL STATLSTICS �'•°-°" '
<br /> .. •., u �._
<br /> ;..�1� ., � ' _. ..•s,.�:;w.: -
<br /> �:,� -:z'.,..
<br /> ,� � � �. � ,a �sv . r sr�ss or�aw�w � � ._ � ,.,���
<br /> �. � �« . - ��:�"`�.. ��,o,� 67 00699 , � ; ._�-=_
<br /> :��
<br /> �„/• . ; ^ u. ataa �aa 1�.. C�t1'II+ICA'1'6 O� DEATH �rArs sns x�....._. _ a„d
<br /> .' �. °�°'"�1M" �TMHall /�•�i� wn ies�w�s�wa..wr��a+„.r�.iw.�...r.w -- : __-.. _--_
<br /> . �isbraska ~•��
<br /> w a�r.Taw.a�wcnnor �.uMSn�a sr��w w �.an.�os�oc�n� «°,.� --
<br /> �,_, _ .
<br /> F .. .. 6 I �� _
<br /> .. �.IMM[OI 1//�M11� r �MM dMMI I.fT�T�OOK! - - �
<br /> 110lMT�L W . .��•'`c-''-
<br /> . . �*�,�� Luthsraa l�ori�►1 Hos ital 8 Eset Do t ; '_��,
<br /> .. � � �.�s�u►a a au► cmr � No •.a�nac«u Ma�os cmr�w�rn � /.���M�sso[wcn � . . -=
<br /> '�__.
<br /> . . 1.IMrI�M /rrlf 1fNft Lw �.o11T[ �fw1� Oy Yrr �} ...F:..-,-
<br /> �� �10I'QSi M01' iiTw f 1 a " -•--
<br /> .s[s • COla1 p1 wAC[ 7 r��[��rtKeM�R11Kp • o�n o�NwTM f 1bM� ru�eu�ttn uw• _,�_--
<br /> 29. 1914 "�°�.Zr�rwa «.�.. .... .a.. u.�. ,.
<br /> ,� _� _ F'smal� I�it� r�oorro0 aw�o Nov. ''
<br />. . ...-� -----�--- -- �� �•b�wMywr ��wMy�1MM1 Id.RrOpNIfM[Lfo11wo11iTR1 11.MOtwIBL fMMMAwM�ww/p) � 1!otf�l�/wMfdlMllln — --- --__�-. r,...
<br /> % SOUSewi�e SOme 0 d Kexiao USA . ,�;.
<br /> u..��TMC••s«ws a►.rot�c�s»s�w►ri �a Mw a��o on nat . '�.,,-
<br /> And w Pae uez S�. Cstalin�► Lo a Re�mo Mor� • .� �
<br /> .. wns aa�xo tKS w v.a�o ro�as� �.soc�s�a�m�a n ��n .w... . �
<br /> �i»..... --- ain�.........w�.�...w ' .
<br /> . .-+„�� 506-22-53e7 _ -
<br /> „ ��.w►ws M wTM latiw..�r�,e«r..i.r w.Ar t.�.��t...�u�d wrc�nrw�nwa« ��' `
<br /> �*�os�n�r�s eawco�+r. o�n Mn n�
<br /> . wrta��t c�r![f�l '"
<br /> e ��� y . ' �
<br /> � .i/Mi eu[ lo p) , �
<br /> �- M�
<br /> �M�w c�.rw (i�
<br /> i. � ���. ou[70 f�! .
<br /> � ►�un r aew�srww ao�aw aor�w��s ro o�nr�ur�w wu►+a a nw w.rwia or�� rw�t�.r w�we.wws tMm� . W
<br /> w
<br /> odasr a�w.��Ko r�x�+»t r�sr�raaast �a .
<br /> � ' ra �00 ,ras �00
<br /> • �or.�oNOrNT �Me�oe aow�ae[ �.ase�s won ruu�r oau�nco fLw.wv�N�./w 1.A.r l w N�M 11 y W.N.)
<br /> ,. • 0 � � . �
<br /> j '
<br /> 1nK OI llwr /�Nne�.D�.Yen
<br /> �� �.�. i
<br /> /��. . . ..�.
<br /> „ �1.Iluwr ooeulMto �oe.nae�a wuulw u.���.�b"«.�wf bw.. �/.tm.towM,011 lou�TO� oovMrr sr�tt ; ,
<br /> 1M�Nd At Q M011rM�1[ O lMA.lMrM�.�trrM.y�w MII•.rrc.)
<br /> ., MOIIR A1IMOIIM -
<br /> ZI. f�If�wAI fA�MM�MI/Mw� ...�� �� . N-,� �� 9=�Q�� -�M W�Mr��11r�M - • .
<br /> . O�fA�wr+/�f �� �ew fM I�b�NNd�M�:��d b fA�MN N wl�nwbl/�./nrn fM wuw�bN/.
<br /> itt.���MI►t11� (0+I►w r fMM) tt0 �oo�lii !!t.o�n s�o
<br /> � t1� M�,pr�� t� p,►T Zk � t d t[�titwr o�t�tw�TWir t]I la�ria�� I rw�.�r ew�r�► l�wl
<br /> sn 11 6
<br /> �I,MRrie �� tOqT�� 2!.R=�I;TI1�111'f fN�����r K,MAM[OI MO�TYI111� �004tff
<br /> I '
<br /> �����6� ✓�, ' •" ��'�/ Livingeton-Sondermarm� arand Ieler:d�Nebr.
<br /> ,
<br /> �
<br /> �=
<br /> r �
<br /> R.�' � I ,
<br /> , �1 --- -
<br />
|