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Kotof El-khair Association Health and community
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Arabic
Orphans form
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Orphans form
Data of the deceased
First name
Father's name
Grandfather's name
Family Name
ID number
Father's date of death
Cause of death
Mother's data
First name
Father's name
Grandfather's name
Family Name
Mother's ID number
Is the mother dead?
Select
Yes
No
Mother`s date of death
Is the mother the guardian?
Select
Yes
No
Guardian data
Guardian's full name
Guardian ID number
Guardian's mobile
Relationship
Contact information
Mobile number 1
Mobile number 2
WhatsApp number
Prefix code
+972
+970
Number of individuals
Original residential address
Current residential address
Type of accommodation
Select
الملاجئ المخصصة للأمم المتحدة
الملاجئ الحكومية
في بيت أقارب / أصدقاء
غير نازح
خيمة
شقة
أخرى
Type of accommodation other
Attachments
Attach a father`s death certificate or statement
Upload 1 Sported File: PDF AR Image. Max 10MB
Attach a mother`s death certificate or statement
Upload 1 Sported File: PDF AR Image. Max 10MB
Attach a copy of the guardian's ID
Upload 1 Sported File: PDF AR Image. Max 10MB
Children
إضافة الطفل الأول
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Data of the deceased
يرجى ملئ الحقول للتحقق من البيانات المسجلة لدينا
ID number
Father's date of death
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