For Brief Account

Please
Encyclope attach
dia Indica Present & Past Imamia Calligraphers, Painters passport
Shiaii & Photographers size
photograp
h
Name..----------------------------------------------------------------------------------------------------------------------------------------------------------------------
Father's Name..--------------------------------------------------------------------------------------------------------------------------------------
Date & Place of Birth---------------------------------------------------------------------------------------------
Teachers..----------------------------------------------------------------------------------------------------------------------------------------------
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Qualifications..----------------------------------------------------------------------------------------------------------------------------------
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Profession--------------------------------------------------------------------------------------------------------------------------------------------------------
A Brief Account of creations/Designs..--------------------------------
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Office Address.---------------------------------------------------------------------------------------------------------------------------
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Local Address..--------------------------------------------------------------------------------------------------------------------------------------
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Permanent Address-------------------------------------------------------------------------------------------------------------------------------
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Office Phone-------------------------------------- Home Phone.-------------------------------------
E-mail.--------------------------------------------------------------------------- Mobile----------------------------------------------
Date of Expiry----------------------------------------------------------------------------------------------------------------------
Place of Death.------------------------------------------------------------------------------------------------------------------------------
Place of Burial----------------------------------------------------------------------------------------------------------------------
Chronogramme (Tareekh) of death..-----------------------------------------------
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Source---------------------------------------------------------------------------------------------------------------------------------------------------------------------
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Name, address, phone nos. etc of person reporting..---------------------
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Signature ---------------------------------------
Date ---------------------------------------
Place ---------------------------------------

Note:- Plz. attach also a post-card size or larger 'full length' photograph
Plz. use separate sheet(s), if necessary

Noor-e-Hidayat Foundation
Imambara Ghufranmaab, Maulana
Kalbe Husain Road, Chowk, Lucknow-3
Mob: 09335276180
Ph: 0522-2252230 - 0522-4062731
E-mail: noorehidayat@yahoo.com
noorehidayat@gmail.com
website: www.noorehidayatfoundation.org