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People's Republic of Bangladesh
MRV Delivery Slip - DHAKA
Enrolment Details
Counter
Deposit Date
Call Date
Applicat1on Type
Purpose Of Visit
Applicant's Details
First Name
Last Name
First Name on Visa
Last Name on Visa
Date of Birth
Present Nationality
Sex
Contact Number(Permanent)
Contact Number(Bangladesh)
Permanent Address
Address in Bangladesh
Visa Printed Date
Received By
Visa No
ENROL20
02/05/2023
25/05/2023 (If holiday,then next working day)
VISA EXTENSION
BUSINESS
KUNIO
MIZUTANI
KUNIO
MIZUTANI
27/07/1976
JPN - Japanese
MALE
8109035973538
8801400562775
Plp2se
Chggk
Your
elivgry
Si3
HAIMUDAITA #105,5-29-11,DAITA,SETAGAYA
KU,TOKYO,155-0033,JAPAN,,
4 FLOOR, NO.60, GARIB-E-NEWAZ AVENUE,
SECTOR13, UTTARA, DHAKA -1230,
BANGLADESH,
Passport Number
Number of Entries
Fee
Fee Receipt
Over Stay Fees
Over Stay Receipt Number
2601V0000524102
TT2295087
MULTIPLE
Operator's Signature
Applicant's Signature