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PHOEBE MADGE FOR,~IEY , Female , Ma 14 1974
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2!L. R. STRZi~GPEi.L.'~~CPT~'.•iC ~ !n:Fitzsimons -Army Medical Center,Der.~•er,Co 80244
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.~i• fLhERAL DtRECT~R-SIGNATURE LICENSE N~. REGt3/Tf AR-S+G`rA•atlE a rAll QU6"~i.i DY CC?i ai G7:TRA>• -
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€ APPROVED: L%/~, y~ ~~~,~.~~~~VAr~EK,
STATE OF COLORADO, Tri-County District Health Department,
I hereby certify that the above is a true, full and correct copy of the '
certificate, in my custody and now on file in my office.
h'itiiess my hand and official seal in Ft2~lewood, in the County of Arapahoe,
D. 174 .
in said State, ti!i~ ~ ~ day of ~ , A.
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Registrar of Vical~~t istics - -
Cou y p~, Arapahoc~J"_orado -
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