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PERSONAL DATA AND EMERGENCY CONTACT   Name:                                   XXXXXXX CHOUDHURY Father's Name:                 XXXXXXX XXXXXXX CHOWDHURY Mother's Name:               XXXXXX SULTANA Spouse's Name:                NA Permanent Address:      BUDDHI MANTAPUR, BUDDIMANTAPUR                                                 MOULVIBAZAR SADAR, MOULVIBAZAR Emergency Contact: Name: XXXXXXX  XXXXXXX CHOUDHURY Relationship:      BROTHER Address:              569/A, UTTAR DHANMONDI, KALABAGN, NEW MARKET,                                 KALABAGAN, DRAKA Telephone No: 018---XX315622

Passport No. BN 0094065   [Logo]

 

 

 

[Signature/ illegible]

[Seal/

MD. XXXX XXXXX

Deputy Assistant Director

Department of Immigration & Passports

Govt. of the People's Republic of Bangladesh

Dhaka.]