| Father Name | : | মোঃ সমেশ উদ্দিন সরকার |
| Mother Name | : | মোছা: লুৎফুন্নেছা |
| Birthday Date | : | 03 Aug 1980 |
| Religion | : | Islam |
| Gender | : | Male |
| Blood Group | : | A+ |
| Nid No | : | |
| Phone Number | : | 01716807052 |
| IP/Telephone | : |
গ্রাম: কিশামত অনন্তপুর, পোঃ গোপীগ্রাম, থানা: সাদুল্যাপুর, গাইবান্ধা
| Membership Date | : | 02 Jan 2011 |
| Enrollment Date | : | 15 Dec 2010 |
| Member Category | : | General Member |
| Nominee Name | : | |
| Relation with Nominee | : | |
| Nominee NID/ Birth Certificate |
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