Household Register

Under Supervision of the Ministry of Public Security of P.R.C.

Household Category

Family Household

Name of Householder

Household No.

Address

Special Seal For Household of Public Security Department of ***Province (seal)

Special Seal For Household of *** Police Station of ***City Public Security Bureau (seal)

Undertake:

Date of Issue:

Registration Card of Permanent Resident

Name

Householder or Relation with Householder

Former Name

Sex

Place of Birth

Nationality

Place of Origin

Date of Birth

Other Addrein This City (County)

Religious Belief

ID Card No.

Height

Blood Type

Educational Level

Marital Status

Military Service Status

Working Place

Profession

When and from Where Moving to this City (County)

When and from Where Moving to this Address

Undertaker:

Date of Issue: