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From transcribe
- Name in full Mrs Anna C Hairsine
- Date of birth Day 17 Month 08 Year 1883
- Place of birth Uxbridge Ont
- Maiden name Annie G Harman
- Husband's given names Carl Hairsine
- Wife's full maiden name
- Father Ruben Powell Harman
- Mother Lucinda Murphy
- Given names of brothers or sisters [Oscar?] James Adda Laura Mary Jack
