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From transcribe
- Name in full Mrs Leiper Vera
- Date of birth Day 25 Month 03 Year 1896
- Place of birth Snider Mt
- Maiden name Ganong
- Husband's given names John Dawson
- Wife's full maiden name Vera Blanche
- Father George Ganong
- Mother Spicer Alice Maud
- Given names of brothers or sisters [illegible] Erna
