| No. | 004487 3476 |
| When Born | Oct 9th. 1898 |
| Name | Charles Jabez Chapman |
| Sex | M |
| Name and Surname of Father | Jabez George Chapman |
| Name and Maiden Surname of Mother | Fanny McDowell |
| Rank or Profession of Father | Jeweller |
| Signature, Description and Residence of Informant |
Mrs Chapman
174 Macpherson av City |
| When Registered | Oct 27th. 1898 |
| Name of Accoucheur | Dr. Foster |
| Signature of Registrar | Jno. Blev??? |
| Remarks | Death Record on File # 1980-05 001474 BN. |
Source: Archives of Ontario; Series: MS929; Reel: 141
Source: Ancestry.com. Ontario, Canada Births, 1858-1913