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From transcribe
- Name in full is Boon George Samuel
- Date of birth Day 15 Month 10 Year 1877
- Place of birth Montreal
- Maiden name
- Husband's given name George Samuel
- Wife's full maiden name Sabina Lydia Maud Broadhead
- Father Albert Boon
- Mother Alice Whyte
- Given names of brothers or sisters Gertrude, Alice, Joseph, William
