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From transcribe
- Name in full is Dolsen Perry Jacob
- Date of birth Day 26 Month 11 Year 1885
- Place of birth Kent Co., near Chatham, Ontario
- Maiden name
- Husband's given name
- Wife's full maiden name
- Father Jacob Dolsen
- Mother Luci Dolsen (Dunkley)
- Given names of brothers or sisters Edith Maude, Arthur, Jennie Louise, Edwin Oscar, Ernest Herman, Alwyn Earl, Phillip, Perry Jacob, Netanis Irene, Glady May
