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From transcribe
- Name in full is Mr. Weymouth Collingwood Brock Schreiber
- Date of birth Day 15 Month 11 Year 1894
- Place of birth Toronto, Ont.
- Maiden name
- Husband's given name
- Wife's full maiden name Libby, Lorna Gertrude
- Father Herbert Harry Schreiber
- Mother Walker Beatrice
- Given names of brothers or sisters Norman, Enid, Caroline, Beatrice, Paris