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Registrant ID: Country: Registration Date (Conflict): Registration Location: Card Type: Serial Number: Registrant Name: Immigrant ID: Age: years Home Address: Birth Place: Occupation / Employer: / Citizenship Status (Country): Height / Build: / Eye Color / Hair Color: / Nearest Relative Name: Relationship: Nearest Relative Address: Nearest Relative Immigrant ID: LPRV-21JUL1906-3-29-0020 Comments: signed: Apkar Dadourian / patient (insane)