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From transcribe
- Name in full Mr Cleaveley Charles
- Date of birth Day 21 Month 10 Year 1883
- Place of birth Rathburn Ont
- Wife's full maiden name Pearl Catherine Bose
- Father Cleaveley George
- Mother Dockrell Fanny
- Given names of brothers or sisters Johnathon Sara Jane Annie William Bert Richard George Mary Thomas Walter [[illegible]by] Joseph Henrietta
