FOUTH GENERATION
Mail to Mrs. Lulu Bray, 2507 Ella Street, Beatrice, Nebr.
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NEBRASKA STATE DEPARTMENT OF HEALTH #455
Division of Vital Statistics, Lincoln, Nebraska
CERTIFICATE OF DELAYED BIRTH REGISTRATION
Name at birth Walter Oscar Bray Date of Birth Febr. 17, 1900
Sex M Birthplace (city or town) Pawnee City County Pawnee
Attendant at birth Dr. John Bullard Address Pawnee City, Nebr.
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FATHER Full MOTHER
Full Name Henry Oscar Bray Maiden Name Susan Lydora Waller
Color or race White Birth year 1865 Color or race White Birth year 1867
Birthplace Nebraska Birthplace Ohio
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ABSTRACT OF EVIDENCE: APPLICANT'S SIGNATURE
(if possible)
1.-Affidavit of older brother, Guy E. Bray, Laurel, Montana,
dated June 26, 1940;
2.-Military Record. Discharged from U. S. Army, dated Nov 12, 1921,
By Colonel of Coast Artillery Corps,
Ft. Worden, Wash. Leslie H. Noble
County Judge of Gage County
Dated December 22, 1941 Nebraska, sitting at Beatrice
(SEAL)
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I certify that a search has revealed no prior birth certificate in this Division for the above named peraon;
that the evidence described in the above abstract was examined by me or a designated agent; and that to the
best of my knowledge and belief, such evidence complies with the legal requirements of the State of Nebraska
for delayed registration of births. This birth certificate is now on file in the Division of Vital Statistics, State of Nebrasla.
Date filed DEC 26 1941 A. L. Miller M.D.
Director of Records and Division of Vital Statstics
Pedigree