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STATE OF NEBRASKA
<br />WHEN TNIS COPY GARRIES THE RAISED SEAL OF 7HE NEBRASKA DEPARTMElU� !�� htEAL� ��4 � x�; ��
<br />HUMAiN SERVICES, IT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE QJZIGIAI�I `2��'�?I�D; 4)N'' ��,�. , a' -
<br />FILE WITH THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES, �iTA�,°�2��DR ;' °-^ � y�,�� � �
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<br />OFFICE, WHICH IS TNE LEGAL DEPOSITORY FOR VITAL RECORDS, , t � �•�.'' s"�'� `� �, �' � '
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<br />DATE OF ISSUANCE
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<br />LINCOLN, NEBRASKA � � :
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<br />STATE dlfltEAi10F YITAL S� STI Sf iiEALT!! � �� ,'� ��� M I "'
<br />CERTiFICATE OF�DEATH �,� ����?r � t:,
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<br />Ragmond � C1aYence Wiagert z. Ma.1e Qcrober 5, 1988
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<br />NAME AND O� iFRTIF (►NY41 tAN. E P U8 ouNr,r ArraA►�r► tr, �, r.,��
<br />Frank Ft�ll M. D. St. Fraacis Medical iGen�er, Grand Islead,.NE�. 68803
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<br />Wiegert Anna � -- Zamzow
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