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From transcribe
- Name in full is Reginald Mortimer Clark
- Date of birth Day 03 Month 05 Year 1891
- Place of birth Campo Bello N B
- Maiden name
- Husband's given name
- Wife's full maiden name [Seoer] S Brayman
- Father John Alexander Frank
- Mother Lydia Dixon
- Given names of brothers or sisters Helen Kathleen
- Florence Jean Wallace John Gordon Donald M Hilda