| Father Name | : | মৃত: মোঃ মফিজ উদ্দিন |
| Mother Name | : | |
| Birthday Date | : | |
| Religion | : | |
| Gender | : | Male |
| Blood Group | : | |
| Nid No | : | |
| Phone Number | : | 01822993164 |
| IP/Telephone | : |
সাং- মাধবপুর, থানা: জয়দেবপুর, জেলা: গাজীপুর।
সি-18, দক্ষিণ ছায়াবীথি, সদর মেট্রো, গাজীপুর।
| Membership Date | : | 11 May 1981 |
| Enrollment Date | : | 17 Mar 1981 |
| Member Category | : | General Member |
| Nominee Name | : | |
| Relation with Nominee | : | |
| Nominee NID/ Birth Certificate |
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