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From transcribe
- Name in full Burgess Henry Lloyd
- Date of birth Day 05 Month 05 Year 1885
- Place of birth Burgessville Ont
- Husband’s given names Henry Lloyd
- Wife’s full maiden name Mary
- Father Burgess Richard Leonard
- Mother Manson Ella
- Given names of brothers or sisters Len Jessie Manning Edna Reeves Annie Patton
