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<br /> HARRY SATOS
<br />HI CHIKUMA ,Hale ,December 2,.1985
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<br />I HEREDY CERTIFY THIS DOCUMENT IS A TRU£ AND CORRECT COPY OF THE RECORD IN MY
<br />CUSTODY AS REQUIRED BY LAN.
<br />Witness Hy n and Seal
<br />NOT VALID WITttOVT This f day of Decemb r 1985
<br />LOCAL REGISTRAP.'S f' Ocput
<br />SEAL CAL REG lU1R OF VITAL ~"TATISTIGS
<br />Ralph R. Nooley, MD, MPtt Registration strict Nutnbe 238
<br />Medical Director Greeley Colorado
<br />WELD COUNTY PENALTY DY LAN if any pezson alters, uses, attempts
<br />OEPAIYCM$NT OF'IiEALTfI co use, or furnishes to another for deceptive use
<br />any vital statistics certificate.
<br />VIII 11111181 IN1111111 NI IItN II dill IIII 1H1
<br />49@.8331 02/2612002 o~.15f dA sukt TsukaWaom
<br />1 of 2 R 10.00 D 0.00 Weld CoanlY CO
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