|
<br />I
<br />
<br />
<br />STATE Of NfI.ASItA-DEPARTMENT Of HEALTH
<br />BUREAU Of VITAL STATISTICS
<br />CERTIFICATE OF DEATH /
<br />
<br />83-')0 13;2 {]
<br />
<br />ore OINT NAME
<br />
<br />liST
<br />
<br />.., ,
<br />
<br />DAT! Of DEAfH (Mo,. ODY. fl.)
<br />
<br />~
<br />
<br />.,
<br />NAM .\NO.. I
<br />
<br />CO "IER (PHVSICIAN, (
<br />
<br />B. D. Urbauer
<br />IlGISlU
<br />
<br />M.D.
<br />
<br />2444 Faidley,
<br />
<br />Grand
<br />
<br />Island, NE. 68801
<br />-rn rE7~~v~o BY IlGISrUI (::0 . D~,. .:".1
<br />!26b..//<t?:..:?,,/1 /. ':'/,J
<br />
<br />~
<br />.'
<br />
<br />;J ,-,./ {,
<br />}.. 260_(I.,_J"~J" ~/;~~~.~_!' I-#I""~",(,~_,, .'-~,j~~.-!._~t ~'"-f.'~ (
<br />21. tNoMtOIATI! (AUS! _ - _ )fHrl' ON!' ON! CAUS, ,ft tlNf 10<< (OJ. ib). AND- (~JJ
<br />
<br />'~., '~!t/.4'" l:-JJ.
<br />l.i t.4.~......- ~
<br />DUE. fO, A 'C H$~OV'fHCE Qf, 1 t _
<br />
<br />1;'-.-1 b......... .".,.,..... d_fll
<br />
<br />J1 >",:}l,~~.
<br />1....__.II~ 000.... OM II...
<br />
<br />,.,
<br />OOf. to, OJ: A$-A CONSlQUfNCf Of~
<br />
<br />'",",,,,01 b___ _1ft 0"'; d__
<br />
<br />kl
<br />'....' 'A~. .... .. ..... . <~. --.- -. ',_'"boo....'... Tc ..... - ,.J:___ 1. ""., lit, i'f flMoAl.. 1. WA5. nuu '" "l.itOPS:'t
<br />. .~ 1 -1-- 1. _ "1'__ _ .. J i...Crft.A.HC'tl...lHUA$UMOtHKS:? I(S--.'~h,t'.,N.'
<br />,I') 1U.}~ ).)~/....-t ,(.,.4""" i T.ol; ...!~ . i.. /->.,
<br />-; Atc:D1.~ '. $UlCtDt.:.ttOw(tDl. uwotl., IQAn 01 WJtJa''f t..., 0.",'" J I-Hout Of ltoun 1 OUC-tll" wow lHJUI.T occut.tO
<br />~."...~-lf'(Vft1tGA~JS~J j __ I I
<br />>00. !,Qti. I >ck .. , "'"
<br />IHlut't,u w-~ PUCI !NJ1Jl'-", ."'-_, f_.... ~..~. JlOC-"'flOH $fUU 0. U 0_"'"
<br />I~ '....-~J .w,. ~...14';...,'" ,r5~,i i
<br />1309
<br />
<br />WA$ (.Ast:_.Ut 010-"",,011:.(
<br />,_..oa<~
<br />v~"'".' .J, ,.."'" N., 17
<br />119
<br />
<br />(In 01 TOWN StAn
<br />
<br />
<br />'THE RAISED SEAL OF THE NEBRASKA
<br />LTH, IT CERTIFIES THE ABOVE TO BE
<br />NAL RECORD ON FILE WITH THE STATE
<br />'UREAU OF VITAL STATISTICS, WHICH
<br />Y FOR VITAL RECORDS.
<br />
<br />~
<br />
<br />..J
<br />
<br />L
<br />
|