The Registration Card for Regular Family Members
(Translation)

 

Number of Residence: XXXXX
Name: XXX
Householder or relationship between householder: Householder/Wife/Only son
Former name: 
Sex: Male / Female
Place of birth: XXX City, XXX Province 
Nationality: Han 
Origin of native place: XXX County, XXX Province 
Date of birth: XXX 
Other address in the same city (county): 
Religion: 
Identify card No. XXX 
Height: XXX cm 
Blood group: 
Education level: Hight School / College / University
Marital status: Married / Single
Military service condition: 
Working at: XXX Primary School 
Occupation: Teacher 
When and from where move to this city (country): No 
When and from where move to this residence: Moved from Room XXX, Unit XXX, Building XXX, XXXxincun, XXX Road (W),XXX District, XXX City, XXX Province on Jan. 31, 2007. 

 

Undertaker's stamp:                                     Registration date: Jan. 31, 2007.

 

Special-purpose Seal For Household Register of
XXX Police Station of XXX Public Security Bureau (Seal)