| Name of Deceased: | Brown, Annie |
| Date of Death: | April 27, 1921 |
| Place of Death: | Oxford St., Ingersoll |
| Sex: | F |
| Age: | 78 |
| Marital Status: | W |
| Birthplace: | Quebec |
| Date of Birth: | February 9, 1843 |
| Race: | Canadian |
| Occupation: | House duties |
| Length of Residence: | 6 years at place of death |
| Length of Residence in Canada: | 75 years in Ontario |
| Father: | Cuthbertson, Nicholas |
| Father's Birthplace: | England |
| Mother: | Munroe, Ann |
| Mother's Birthplace: | Scotland |
| Informant: | Brown, Calvin |
| Informant's Address: | Ontario |
| Relation to Deceased: | Son |
| Place of Burial: | Delmer cemetery |
| Date of Burial: | April 27, 1921 |
| Cause of Death and Length of Illness: | Carcinoma |
| Did an operaton precede death? | No |
| Autopsy? | No |
| Date of Registration: | April 27, 1921 |