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From transcribe
- Name in full Mrs Countryman Maud
- Date of birth Day 6 Month 11 Year 1895
- Place of birth Grantley Ont
- Maiden name Maud Hesson
- Husband's given names Elburn
- Wife's full maiden name Maud Hesson
- Father Hesson Alexander
- Mother Shaver Annie Lacrushe
- Given names of brothers or sisters John Cassie Herman James