| Father Name | : | |
| Mother Name | : | জেহুরা খাতুন |
| Birthday Date | : | |
| Religion | : | Islam |
| Gender | : | Male |
| Blood Group | : | |
| Nid No | : | |
| Phone Number | : | 01710783227 |
| IP/Telephone | : |
বাড়ী-১/২ (আজিজান-৫), হাজী ইউসুফ আলী সরকার রোড, আউচপাড়া, টঙ্গী পশ্চিম, গাজিপুর-১৭১১
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| Membership Date | : | 13 Oct 2008 |
| Enrollment Date | : | 27 Sep 2008 |
| Member Category | : | General Member |
| Nominee Name | : | |
| Relation with Nominee | : | |
| Nominee NID/ Birth Certificate |
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