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<br />� 9�9 106748
<br /> WHEN THIS COPY CARRIES THE RAISED SEAL OF THE NEBRAS'�A STA2E
<br /> DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW 'TQ $� 'A, 'TRUE CQ�Y
<br /> OF AN ORIGINAL RECORD ON FILE WITH THE STATE DE�At�fi�,,�F�,H�AI.TH
<br /> BUREAU OF VITAL STATISTICS, WHICH IS THE LE�: �������aR
<br /> VITAL RECORDS. � � � �� � .����� �:,�""�,
<br /> �: � ''
<br /> •'i P '�A. ,���s
<br /> DATE OF ISSUANCE .� ' �� '
<br /> d.... . . _.�°��..«� ;
<br /> OCT 1 O��5 ST�-�i���,���;�' �CTOR
<br /> BUR�AU`�(�F�`�,�°�' I:' S ��STICS
<br /> LINCOLN, NEBRASKA "�` � �:
<br /> � .:w.- ;,• _,
<br /> STATE OF NEdRASKA-DEPARTME!!T OF HEALTH
<br /> BUREAU OF VITAL STATISTICS
<br /> CERTIFICATE OF DEATH k� !�Y -
<br /> DECEDENT—NAME FIRST MICDI U T SEX OA E Oi AiM(Me.,Der.Yr.)
<br /> � Raymond DeWa ne Patterson zMale � September 24 , 1985
<br /> RACE—(�.y.,Whi��,llxt,Awhricon ORIGIN/OESCENT(�.y.,IMlion,bl�aican. AGE—�mr�inMey UNOER 1 YEAR UNDER 1 DA� DATE Of 61RTH(Mo.,Doy,Yr.)
<br /> Indion.�k.)(Sp�cifr) C+�rnqn.Nt.)(Sp�si/r) r �Yrt.) MOS. � OAYS MOURS� MINS.
<br /> ., White s, American U �. 35 6b. ' �. � �. Januar 31 1950
<br /> Clil�AND STATE Of 61RTN(N nol iw U.S.A., CITIZEN OF WMAT COUNTRtl MARRIED,NEVER MURRIED, NAME Of S►OUSE(I/ril�,yiw n�eid�n no�n�l
<br /> now»ceun�ry) M/IOOWED,DIVORCED(Sp�ci/y)
<br /> e. Winchester , Va. � ,v. U.S .A. �o. Married �,. Marlene F. Harrie
<br /> SOCIAI SECURIT/HUM6ER USUAI OCC � flON(Gir�kind olwo�k don�durinp nwsf KINO Of SUSINESS OR INDUSTR`! COUNT!Of DEATN
<br /> el rerkinp li/�,�wn i!nNnd� P e�S 1 CO 1 3
<br /> ,z. 225-66-8380 �ao.Salesman Truck Driver t36. CO an ,,,. Lancaster
<br /> CITY,TOWN OR IOCATION Of DEATM INSIDE CITf IIMITS MOS►ITAI OR OTMER tNSTITUTION—Name ����e������h��• ����'O�INSi.Indi�eN DOA,
<br /> (Sp�ciir Y�i or No) yir�dnd and numMr
<br /> J S t. E 1 i z ab e t h � S �"roO������E.«.R.'i"Pen.�r lSp.r�l�)
<br /> ,•b. Lincoln �k. Yes �ad.Communit H ».. In atient
<br /> RESIOENCE—STATE COUNTY CITI.TOWN OR IOCATION STREET AND NUMlER INSIOE CITY IIMITS
<br /> (Sp�ciyY e SNo�
<br /> ,seNebraska ise. Hall �x. Grand Island �sd.909 So. K�mball ,s..
<br /> fA HER—NAM IR T MIOOIE UST MOTHER—MAIOEN NAME fIRST MIDOIE U
<br /> ,s. Donley Patterson , Edith Everhart
<br /> WAS DECEASED E�ER IN U.S.ARMED fORCES� IN�ORMANT—N�ME—RElA1lONSHIV—M/tIIING ADDRESS (STtEET OR R.F.D.NO..CIT'O�IOWN,SiATE,I��)
<br /> cY.,.�o.o.�.ullllyn,qi.��.o.onddo�ne�»..;<., WIFE : Marlene Pattersonlsland Nebraska 68801
<br /> ie. NO �0.909 So. Ki a
<br /> BURIAI,Cr�motion,Re�oval DAT S e p t. 2'] � CEMEIERY OR CREMATORY—NAME LOCATION CITY OR TOWN STATE
<br /> zoe. Bur' � �. Y985 zo�.Grand Island Cemeter �od. Grand Island, Ne .
<br /> EM/AlM AIURE 6 UCEM E 7 � fUNERAI MOME—NAME AND ADORESS (STRfET O��.�0.NO.�VT1�O�?OWN,STATE,II►1
<br /> ��L/ ' APFEL-BUTLER-GEDDES FUNERAL HOME
<br /> 21.: � 2456 ,�.1123 W. 2nd St. Grand Island Nebr ska 68801
<br /> E f AT (Ab., er,Y..) 'L(� DATE SIGNED(Mo.Do�,Yr.) MOUR Of DEATH
<br /> zW
<br /> F <_
<br /> �v Y3a. '� �V � eN� 240. �16. M
<br /> ��' DA1E SIGNEO( o.,Day,Y..) H UR OF DFf�TM� i=C PRONOUNCEDDEAD PRONOUNCEDDEAO(Hou./
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<br /> � M `�W� 44c. 4 .
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<br /> �'f To IM b�N o1 w�.knwl�dq�,dwM � r�d o��M Y or�ond p�x�ond du�ro rM a�u On M�beai�e1•.o�w�wonon end/e.inv��NqoNen,in�oyinion MatA x�un�d o1
<br /> e ce�w(q�ror�d. . fb�inw,do��oed Ploa�end dw M M�co+rp)�fabd.
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<br /> 2�d.(�9nM�r�od►iH�l� � 24�.(SipnWun ond I�M�1�
<br /> NAME AND ApDRESS Oi CERTIf�ER ICIAN, RONE ' HYSICIAN OR COUNTY ATiORNEY)(iyp�er irinl)
<br /> z3 R.W. Gillespie , M. D. 770 N Cotner, #215 , Lincoln, Nebraska 68505
<br /> REGISTRA� � DATE RECEIVED 6Y REGn�R�R(Mo.,Doy,Yr.)
<br /> OCT 2 �� �
<br /> 260.(S�ywelrnl� 26b.
<br /> Z7. IMMEaAiE C SE (ENiER ONtY ONE CAUSE 1 LI E OR(o),(b),AND(cl) ; IIN�M1OI b�MM MN/OI1A dMM�
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<br /> ►ART��S NIf1CANT CONDIiIONS—C�ndi�ion�cwrril�tinq w�A by�� ��oNd ►ART III.If►EAUIE.WAS TMERt A AUTWSY WAS CASf�EfER�ED f0 MEDKAI
<br /> MEGNAHC'/IN TN!►AST 7 MONTMSI /SpKil�Y w Ne) FXAMINER O�C �ONl�
<br /> 11 ^ !Sp«i!� «w
<br /> l� Y��� No ❑ 7 29.
<br /> ACCIDENi,SUICIDt,NOMICIDE,U T, i d INIUlY(AM.,Oe�,Yy.-- MOU�Of�WURT DESC�I�F MOM�IIUUM�OCC EO •
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