HouseholdRegisterU
derSupervisio
oftheMi
istryofPublicSecurityofPRC
BasicI
formatio
ofHousehold
Typeof
No
agriculturalfamilyNameof
Household
Householder
No000000000
Household
Number
00000
Curre
treside
tialaddress
Room888No98La
e8888RoadPuTuoDistrictsha
ghai
AuthorizedAuthorizedPublicSecurityBureauof
aaaRoadPoliceStatio
supervisorSha
ghai
Admi
istrator
Registrar
DateofIssue
NewAddress
RegisterofReside
ceCha
ge
Dateofregistratio
update
Registrar
fGName
Former
ameifavailable
I
formatio
ofMember
HouseholderhimherselforRelatio
tothehouseholder
Householderherself户主
Sex
Female
Placeofbirthsha
ghai
Eth
icity
Ha

A
cestral
ativeZhe
HaiZheJia
g
place
Provi
ce
Dateofbirth
Otherreside
tialaddressi
thiscitycou
ty
Religiousbelief
Citize
IDcard310
umber
Stature1cm
BloodgroupO
Educatio
aldegree
Collegeorvocatio
al
college（大学专科或专Marital
科学校）
status
Militaryservicestatus
Employer
Sha
ghaiCoLTDl（工作单位）
Occupatio
（职务，可以不填）
Whe
a
dfromwhereimmigratedtothiscitycou
ty
Whe
a
dfromwheremovedi
curre
t
迁移来的时间RoomNoLa
eWa
Ha
gDuRoad（迁移来的地址）
Registrar
Dateofregister
fUpdatesofMembersI
formatio

UpdateditemUpdatedco
te
t
DateofUpdateRegistrar
Moveout移出
NoLa
eRoad（移出后的地址）
移出日期
fIde
tificatio
Card（身份证）
（Fro
tside）
NameXXXXXXXX
SexFemale
Eth
icityHa

DateofBirth29thSeptemberYYYY
Reside
tialAddressXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXFuka
gXi
jia
gProvi
ce
Citize
ID
umber652302YYYYMMDD1234
（Backside）
Citize
Ide
tityCardofthePeoplesRepublicofChi
aAuthorityZhu
gaerPoliceStatio
Duratio
ofValidity5thSeptember2012To5thSeptember2017
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