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| Full Name | Mohammad Shah Alam |
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| SSC Batch | 1987 |
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| Father's Name | A K M Rafiqul Alam |
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| Present Address | Flat-A2, House-1202, Avenue-11, Mirpur DOHS. |
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| Blood Group | A+ |
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| Occupational Address | Asgar Ali Hospital,111 Gandaria, Dhaka. |
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| Permanent Address | 424/8, Shimultoli, Gazipur-1703 |
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| Mobile Number | 01883433303 |
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| Payment Information | |
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| Date of Birth | 01/01/1972 |
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| Member Type | Lifetime Member |
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| National ID No. | 3353098235068 |
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| Present Occupation | Doctor |
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| Membership fee (Lifetime) | 5000 |
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| Payment Option | bKash |
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| Sender Mobile Number | 01883433303 |
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| Approved? (Admin-only) | |
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| Agreement |  I agree to the privacy policy.
I hereby declare that the information above provided by me are true and correct to the best of my knowledge. I hereby sign this form to register myself to be member at the Gazipur Cantonment Board High School Alumni Association. |
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