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<br /> ' WHEN THIS COPY CARRIES THE RAISED SEAL QF THE NEBRASKA STATL y �
<br /> I DEPARTMENT OF HEALTH. IT CERTIFIES THE BELOW TO BE A TRIIE COYY
<br /> I pp AN ORIGINTALRSTATISTICgILWHi�HxISHTHE LEGALED�O�TORYFFOR�TH _
<br /> ! BUREAU OF VI �
<br /> I VITAL RECORDS. n
<br /> � ��e� �
<br /> ; �
<br /> �I DATE OF ISSUANCE .
<br /> �
<br /> � ��9� STANLEY S. COOPER, DIRECTOR
<br /> � LINC�OI.N. NEBRASKA BUREAU OF YITAL STATISTIC5
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<br /> �� end d STATEOF NE�M4Kl►—QEPANfMENT OF NEALTH .� 98�' �l��l��!
<br /> �VEm�ar 4, 1992 ���uppyRAlBTAT1811C8 � •
<br /> � CFRriFiCATE Of OEJ►TH `", �)�^
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<br /> t.OECEDENT•N ��T
<br /> Sylvanus John Happ Male Se tember 29 1g92
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<br /> 501 18 5491
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<br /> !Oa GrnrONWa�K !0�DATE --- '
<br /> � 10/3/1992 Sacred Heart Cametery Greele NE 68842 �_ .
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<br /> Univcrsity Placc, an Addition to the City of Grand [sl:�nd, 1-iall C;ounty, Ncbraska,
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