| No. | 032091 18 |
| Name | Box |
| Sex | M |
| Date of Birth | 20th. Oct. 1901 |
| Name of Father | William Charles Box |
| Maiden Name of Mother | Clara Kneeshaw [sic] Learoyd |
| Residence and Occupation of Father | 6 St. Andrew W. Labourer |
| Name of Physician in Attendance | W.F. Brown M.D. |
| Name of Person Making Return | W. C. Box |
| Date of Registration | 21st. Oct. 1901 |
| Remarks | Twin |
Source: Archives of Ontario; Series: MS929; Reel: 155
Source: Ancestry.com. Ontario, Canada Births, 1858-1913