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From transcribe
- Name in full Mr Van Blaricom Earl Winfield
- Date of birth Day Month Year
- Place of birth Sidney Township Hastings County Ontario near Belleville
- Wife's full maiden name Vera Kathleen Van der Water
- Father Van Blaricom William
- Mother Stickney Mary Elizabeth
- Given names of brothers or sisters Charles Van Blaricom of Spritwood Sask deceased