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Household No.: xxxxxx
Applicant signature: Public Security Department (sealed) The undertaker signature: Register date : xxxxxx ,20xx
(sealed) (sealed)
Nanjing Service Center for Human Resources Nanjing Public Security Bureau Household Special Stamp Household Special Stamp Police Station of xxxxx
Male one
Male
two
Male
three Updates of Member's Information
Female one Female
two
Female
three