People's Republic
of
Bangladesh
MRV Delivery Slip -
DHAKA
Enrolment
Details
Counter
Deposit Date
Call Date
Application Type
Purpose Of
V1s1t
Applicant's
Details
First Name
Last Name
First
Name
on
Visa
Last
Name
on Visa
Date of
l31rt11
Present NaI1onality
Sex
Contact Number(Permanent)
Contact Number(Bangladesh)
Permanent Address
Address In Bangladesh \/1sr1
Printed Date
MRVENROL07
09/06/2026
23/06/2026 (If holiday, then next working day)
VISA EXTENSION
EMPLOYMENT
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HIROSHI l a,e\X
{dfsport
Number
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KAJITANI c'r-eCV... J ('{"\\$\~
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Nuiber
of
Entries
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KAJITANI ,~C\.
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Fee Receipt
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21/10/1981
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Over Stay Fees
JPN -
Japane~O cO
e Over Stay Receipt Number
MALE
81332724631
01787690857
2-34-4-303, MINAMISUNA, KOTO-KU, TOKYO,
JAPAN,,
ROAD-96, HOUSE-8. APARTMENT-A3, GULSHAN-
2. DHAKA-1212, BANGLADESH,,
Received By
Visa No
II
III
II
II
I
II
II
IIII
I
Ill
II Ill
Ill
I
II
II
I
1111111111111111111
2601V0000653574
TT4072282
MULTIPLE
Operator's Signature
Applicant's Signature