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From transcribe
- Name in full is Clarke Jervis Eastman
- Date of birth Day 30 Month 07 Year 1886
- Place of birth Actons Corners, Ont.
- Maiden name
- Husband's given name
- Wife's full maiden name
- Father Rev. C.B. Clarke
- Mother Amelia de Percier
- Given names of brothers or sisters Wm T. Clarke, Noel R. Clarke, Guy de P. Clarke
