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U N ~ CERTIFIED. COPY OF VITAL RECORD
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N 3 O m STATE OF NEW MEXICO COONTY OF BERNALILLO-- ? -
a w ~ ~ Michael J. Burkhart, Director ~ '
` z a w a Health Services Division `
w ~ Health and Environment Department
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H >t W " 0D
A ca z ~ This is a true and exact reproduction of the original document
~ w H , vt officially registered and placed on file in-~~t#[e~ ~ "fal Records
~ > w ~ oc ~ Section of the NeW Mexico Health and Snviro~'at artmeat in
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F, ~ a Santa Fe, Ner Mexico, and issued under. =~u~ State
z z x ~'i Registrar of Vital Statistics. -
a a w w DATE ISSUED : Jltrle 20, 1979 ` ~ ~ j
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