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From transcribe
- Name in full is Mrs. Dimock, Maud Clarence Lewis
- Date of birth Day 04 Month 12 Year 1885
- Place of birth Newport, Nova Scotia
- Maiden name Annie Elsie Maud Forrest
- Husband's given name Clarence Lewis Dimock
- Wife's full maiden name
- Father John Forrest
- Mother Eleanor Meek
- Given names of brothers or sisters John Eiskin William Stanley, [?] Ezra, Margaret, Elva, Hessie, Alice, Jane Forrest