Laserfiche WebLink
.:.�: . ,. <br /> � _,.�._ . . .. <br /> . .. :. .. . . y - <br /> , ._.. -._ <br /> ....... .. . ...... <br /> ! .`'.E:;��;::�;: <br /> . <br /> „ <br /> .._ - - <br /> ,. .. ... ...._ . . .. , _ ,. <br /> rrourmeiT MISSOURIDEPARTMENT OFHEALTH gt�TFFILF�lUMElE� <br /> �N C�RTIFICAT�OF DEATOi qry/� ��,���,� �� „ <br /> otnu�u�nt ' I G�T ° ��`'� ��1� <br /> .. 0�►CRixx. qE01ST{1�1�ONUiSTiiiLTNO I�� f�E61STRAf1"SNUMflEH - -- -' --- �'-- ' ' - � <br /> /Op --'-'—"—'� �� ].",F� 1 b�tl'O�Uf�1��l�ann�n OIr ��+�r <br /> �HlfllUCiION� �oecenu��N.ue rs:.,�u�aan wn AUGUST l H, 1996 <br /> i ,u onue not BISHOP MALE' <br /> I No��.NO.00K. RALPH JULIUS • -----'-�----— <br /> � OG��I IGU�ut�Nt� H�GC•uu 6n VNpl.n�rP.An 5c u�+oEn i D�• e oe r�a n�nn„ti..,,,��O�r�r.+•� r pmumiec��C,r�n�a suu��.ln,r.o�f����^�,r� „ <br /> I e'"°0°"••,�" """�,,, ,•�� ""' """"' APRI� B, 1918 GRAND ISLAND, NEIiRASKA __ <br /> - .r, <br /> � 508-10-2629 ?� �_ �^ -----_..�� - - � <br /> 'n we�rivioe�r�i tven m 0�PLACE 0►DE:ATH �t�ecM o�d�o_:o.ton uuuuchun�m�uv�or uJOI--- ._ - _ .. <br /> ' uB �GUlpronCln+ ,� • <br /> � �1'� ❑Y�t �No �Un1 NG�1►ITAI ��nF11UCnt �GLI/OutpnUCnt ❑DOA OTNL�' I_J Nursmp�lomo U I�p1�Jnnr.n��U�hm��pot�ryl JT ----, _ ._. <br /> �.�co ' OaC�frloW��OnIOCeiinqWPr�n�y ?icn�MrntOF�u� <br /> 0o f+-cn��,H�w n;�,;,����„r,o�o•••u,••�•^a�„mn.n EiElAN50N TANEY <br /> �,tieo oa�+ - <br /> � a� p SKAGGS CCa'1MUNImY HGALTH CENTER [ _.. _ __ - - - - •�---_ - - �. <br /> �?�UT.cIOtr�iBUSU�tncCU��n0�+�0•..���n�r �JnK��roO�uoS���FS;�nu�quSTnr ,-°�" <br /> � �04Mt1ulB��IVO•w�+�n0 N�d� n 9UnVrvM061'OUSGS���ti�f wm�awou� �urrw✓nmpi,��Panoluv.��•�en _ . �»J'. <br /> ���..,bw,do.�a.o,,.a��,.��..,, ,��.,,..o,..n,��m,.a��.,m„ drlNE�m SIGN COMPANY r�,. <br /> MARRIED IRENE Rr1THBUN -- �Mnocooe ,,;�;� <br /> 6 t�c Ci r r.row�+.a��oc�i�or� <br /> � �)IpFB�DfNC�•STATG ��DCDUNtY r_ .��� <br /> NEBRASKA HALL GRAND ISLAND 68803 � <br /> = iL3TAE11/►NONUMBEN �Y��S10fdtv�mitg uqrE��SAI�nF.SENiAOR�E55 <br /> g 4016 �IASON AVENUE �vus ❑No ❑undors ❑5-9 Oto-�9 �2oormaro ___ - <br /> a �1wA`JO[CEOFNTOfMSo�N�C0��6�N ISfU[:FMen��ninAnnOinc�w�.��.r�c �uDEGLOENi$EP1iGAT10�/ , <br /> fSPeohNnpifYl•//�IlIpPC�hCuDM.410a�fJnhenoA�eN��e1 lSOnhl �Sroc,�yonryn�pnonp��d�rompie��nl " <br /> � F.�o��e��aVl,�•[on����10�?I CMIeptl�•1o.3.1 :,,__ <br /> e WHITE i4 .__ -- <br /> . +� CKNo ❑YCS Spoclly: ^" <br /> 4� �1{A1�RA6NnYFIintlUJUIw.U{tl 10 NOIH6A9q�ME1lnfl./A.WIONr�tlMSmn�mel <br /> %,i,_'. <br /> JULIUS B�SHOP MAE LAURIT2EN __. <br /> � 11!�NLWUA.NTSNAMFI�lp��MJ 19e 1JAllINp�DORESSfSIro•t�nAlA�mDl�aRU��iAd+tlNumDO�L�ryo�TOwn.S'+�e Z�pCOGeI s•� <br /> ' IRENE BISHOP 4016 MASON AVGNUIE GRAND ISLAND, NEB. 68803 �;�:-- <br /> v y,- <br /> * 701 BUNW.Cp�4AT10H. NC OATE OF D157051TION Mc PIACE OF OI�OOS�TiON M�me pfpm�qry.nemnory.o� 200 LOC�TION•Gry o�Town.51�N � - <br /> OTHfN fSpK�yl (NOnn�O�.YNrJ olnx uCH <br /> •�. , ., , BURZAL AUG. �L2. 1996 GR1�E�iD ISLAND CITY CEMETERY GRANA ISLAND, NEBRASKA _ :���: <br /> 3 W. NORTH FRONT ST• 72bNNE�7ALESiABUSHNENT ____ <br /> • 7�$�dxAIURE 0�NNE�� CE UCENSEE OH J7�N�YE�.NO�ODHESS Oi iACII�TV� �i E 5 UMB�� �-,`�".. <br /> PER AChHOA55 KLEINE FUNERAL HOME GRAND ISLI�ND, NEB. 68803 ��1�� �:��-� <br /> I7 RIIEnIfeP� i N If��VMAOft Y40NIh�IGU0MN10�l1�Do�u��nurlh�moE�otEHnO.�u��seoaaeornsouo�oryunit.lno:..aneinl�nuro �O f11tnEDellhMl9]MNn � <br /> �{f10/JrOn OIIIIC�Iin� /�� � /� l�riO� � — <br /> 6EE IMYFDtATFC�U,".E � e� � W�/�J�-- �"L � <br /> v3TPUCTIOH3 (FvyOrsef�or puET01011A9ACpNSE04ENCE0�1 � <br /> •HOTHERS�DE caw�onnfNb�D /��1 � <br /> _-_ �ndnn� b.�TCqiO tJU1L `h. _ —'_ � <br /> � - S�pn�t��hbf� DUEi IOBAS�CQNSEOUENCEO�I � <br /> caaiom��ny. /� � ,L�1w <br /> HWp townw�au /u 1 �//LG — <br /> cNx Emu C. `�.(.i/����-1'LL--� � <br /> UTAERLYWO CAUSI OUE TO 1�A9�C NSE�UENCE O�) � <br /> ldxlt�aW�ry�N' � <br /> fIMYI1d MMI!rlsV� � <br /> 1 /na/1N)IAST d. <br />- ' PARTIION�ffWNlleanlablYWCW�Ir10vYnp100�a1hWlnOl�qullkpinl��uMHtylnpGUf�OhenlnPaNl 2�.ifM LE156 9WW 56HE J�ERFORJEOtPSY 13b VAMBlEO ON OINOS <br /> ' PPE6NIW T IN i NE LAST COWPLETION OS GW SE OF <br />.- �• 900AY87 OEAiM� <br /> � ❑Yes ❑No C�Unk. ❑Voe No ❑Yus o <br /> tEMAIPIEAO/OEI�TH ���OATEOIINJURY z���NJUf1Y =��REUTF.Divd�~qL ��a��upYATWORKf ?I�OESCpiBENOWINJUNYOCCURHEO <br /> � y (u0n��.DiY.Ylar) <br /> L'l ❑Vnnd�M ae.aw v_ — _ <br /> I N1I�It1 1 YO�lQ14on – <br /> ' ❑ACtdrn� M ❑YH O No O Unt. ❑Ya��No O Unk ��� <br /> •.,.,•.• . , � ❑SukN� ❑C�Id�� ?71CLACEOFINJURT.AIMnw.lue.tlr„I.f�clory.otlie� �I�IOC�tiON(SnNt�nGNUmOOraRwalROUi�Mim[�r.C�yO�TO.nbi�t�l <br /> � - ONaw.M EuaO�+q.�ICpMny) <br /> '�� ❑Nwnd� <br />-'" �i�'.: tM.lSpn/Yl J6D701MOwlo/mllnowle �.AU xcun utNUm�.d� Ct �am��om�nm�t+i��nw 3Le.DAiL6i6NE0 JLO-TmE9FCEA�H <br />'' (AfMlh�JY.rl1r� ,,±�� �,I.��� �_ <br /> •,� • �(`�(`7(0 �� r M <br />-. '::. <br /> �.+, [�XG(ITIFYIHOVMY61CtAN (Srpnifuroend i��le _ <br />- OMODICAIlRAMIN[IVCORONER � yp��CENSEtN�.!BEA ]OV!►SC+�SEQEFERREDTOMEO�C��Bw�M��+fp�COPONEP� _ _ <br />–r_ ��."'�• �s NAYF PxOADDHFSSOFCNI�FlE11(N1YSiC��1V.Y�b/GLEX �H COBONEB �Wa7i•ny — —_-- � � � <br />_���..�`'�,; DR. SiANLEY HUIiNER--BRANSON, . 65616 84�1�tP ❑vos [�No � <br /> 7�D�1E AECE�VED BY l�'!L NE6�StN/U7 <br /> - - ]t N�uEOFATtENOlu6PHYS�p�NiFOtNEeTNANCER�K�FA 07AEO�S1 �9SION�IUAE /uo�tn O+r Yr+�l <br />__m•.i4�...L . '. I t�{�I or RNrJ , y^' /)�_/ � �� � <br />�.y�'J�._ .\.l R.� /7 <br /> �_ ( r"_ <br /> ���YM• • . .._ . . . .� • ' __ <br /> ` '•'0 THIS lS A CERTIFIED COPY OF ANORI OINAL OOCUMENL rE <br /> . � (po rtof eeeopt(l rephotog�aphed.or fI seal lrnprosslon cnnnot bo lolf.) �'i'�-_ <br /> ti <br /> r ----_ __-- <br /> • } THE REPRODUCTION OF THIS DOCUMENT IS PR011181TED BY LAW(sec.197.316,R9Yo 10E8) _ --- ! <br /> �� � BTAT�OF IAISSOUfII 1 �r�.�-�._--m°- <br /> t� j �s 1 HEREBY CERTIFY Ihat lhls Is�n ex�ct reproduetlon ol lh�c�rtltic�ts for lhe person n�m�d lh�rNn��It now�pp��n�^��� <br /> :'.�:�{r�s�'�_,_ <br /> . T permancN reeads ot Iho Bur�au ol Wtd R�corAf o1 Ih� Mlffourt Dep��lmenl of He�AA. Wllnen my hend n County Registn`of_VII i SuqaUc��nd��8e��� : ra43__?=-�_V- <br /> Ih�Misfourl OePa�m�nt ol Heatth IMs dale ol 'Q h�'` .� ~` s- - <br /> (� � IW. 'yt+ � <br /> �— �L-'"� � Rtqlstnr ot Vlt�!St�Hstia •,�•-.-•:-+.;�;F. <br /> . . ..c,,..�._.._ <br /> ° ��oseo•��c�aevi Stephen C. Tullos .._. � ." �._ ti�. <br /> EXHIBIT "A•' . . �� <br /> , • - ______ <br /> —___._-^-..�.--_.___..-.�.,.-__._..---- ------ - . <br /> ,_ . _ ,_ _�. _.,.--�---.. . - r-- <br /> _ t', . <br /> i ' ., <br /> i <br /> �._.l _ <br />