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<br />WHEN THIS COPY CARRIES THE ~ISEb- SEAL OF THE NEBRASKA STATE
<br />DEPARTMENT OF HEALTH, IT CERTIFIES THE BELOW TO BE A,cTR1.J}!; COpy
<br />OF AN ORIGINAL RECORD ON FILE WITH THE STATE DEP.t\R~'Q :qFiH~TH
<br />BUREAU OF VITAL STATISTICS, WHICH IS THE LEGAL D'EPOsltoay,.~FOR',
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<br />JAM t 2 1981 STANLEt\:S.',_-.??~PE~,,";~~RECTOR
<br />BUREAU o.F,l(J~41. .'~1ATISTICS"
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<br />LINCOLN, NEBRASKA
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<br />STAn Of MllRASllA-OEPARTMENT OF HEALTH
<br />IUREAU OF VITAL STATISTICS
<br />CERTIFICATE OF DEATH
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<br />SOC'A\ SlCUItTY HUMIII
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<br />InIDIHCI- STAn COUNIY
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<br />Ellen L. Totzke,
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<br />Hall County Attorney Grand Island, ~E 6~80l
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