1. Name ............................................... ..................... Name ................................................. ....... Name ................. Date of birth ................ ............................................ Month BE ...................... Age ................. Pig blood ................. Nationality ......................... Ethnicity .............................. ............................... Religious identity card number .................................................. .................................................. .............. ................................ Hometown No. Mu .............. ................................ Village , district, provincial .............. .............. Code ............................. homepage ......................... Mobile .................. current address at .................................. Mu .............. ........... Village parish road ................. ......... District ...................... Province .............. Code ................................... Home Phone ......................... Mobile ..................... E-Mail .................. ..................... Facebook ......................................................................................................
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