| Back | 请登记你的姓名、年龄以及供养的亲属的人数。 |
|---|---|
| Front | qǐng dēngjì nǐ de xìngmíng niánlíng yǐjí gōngyǎng de qīnshǔ de rénshù Please state your name, age, and the number of dependants you have. |
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