Type of Household:

Non-agricultural family

Name of Householder:

Household Number:

 00000

Current residential address:

Room 888,No. 98, Lane8,888Road,

PuTuo District, shanghai

Authorized supervisor:

Public Security Bureau of Shanghai 

Authorized

Administrator:

aaaRoad Police Station

Registrar:

Date of Issue:

New Address

Date of registration update

Registrar

Name

G

Householder him/herself or Relation to the householder

Householder herself

戶主

Former name (if available)

Sex

Female

Place of birth

shanghai

Ethnicity

Han

Ancestral native place

ZhenHai ZheJiang Province

Date of birth

Other residential address in this city (county)

Religious belief

Citizen ID card number

310******

Stature

1** cm

Blood group

O

Educational degree

College or vocational college（大學(xué)?？苹?qū)？茖W(xué)校）

Marital status

Military service status

Employer

Shanghai *******Co;LTDl

（工作單位）

Occupation

（職務(wù)，可以不填）

When and from where immigrated to this city (county)

When and from where moved in current

遷移來的時(shí)間

Room***,No. ***, Lane**** WanHangDu Road, （遷移來的地址）

Registrar:

Date of register:

Updated item

Updated content

Date of Update

Registrar

Move out

(移出)

No.**, Lane****, ***** Road

（移出后的地址）

移出日期

（Front side） 

Name: XXX XXXXX

Sex: Female                          Ethnicity: Han

Date of Birth:  29^th September, YYYY

Residential Address:  XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX, Fukang, Xinjiang Province

Citizen ID number:  652302YYYYMMDD1234

（Back side） 

Citizen Identity Card of the People's Republic of China

Authority:  Zhungaer Police Station

Duration of Validity:  5^th September, 2012  To  5^th September, 2017