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Nairobi Data Collection 1434H

Anjuman-e-Saifee, Nairobi - Data Collection 1434H - Compulsory for all Mumineen above 18yrs of age.

Personal Details
ITS52 Number *
(Ejamaat Number)
Title *
• Shaikh
• Mulla
• Bhai
• Bahen
Dawaat Title
NKD, NDI, MDI......
First Name *
Middle Name *
Surname *
Previous Family Name (Surname)
Fathers Name
Spouses Name
Cell Phone (Primary) *
Email (Primary) *
Cell Phone (Secondary)
Email (Secondary)
Cell Phone (Other)
Home Phone (Landline)
Mohalla *
• Shujaii (Runda)
• Jamaly (Hurlingham)
• Mohammedi (South B, C, Nairobi West, Embakasi)
• Hakimi (Pangani)
• Burhani (Town)
• Husami (Westlands)
• Najmi (Parklands)
• Saifee Park
• Outside of Nairobi
House Address (Physical) *
[If Saifee Park - Enter House/Bungalow Number]
City *
Number of Children (Under 18yrs of age) *

	0	1	2	3	4	5	6	7	8	9	10
Select a value from a range of 0 to 10.

Blood Group *

Business Details
Occupation
e.g. Sales / Marketing / ........
Profession
Architect / Engineer / Doctor / .......

Business / Service Details - ONE
Business Name
Business Phone (Primary)
Business Email
Business Website
Business Type
Glass / Hardware / Import / Catering / .......
Main Products / Services
Other

Business / Service Details - TWO
Business Name
Business Phone (Primary)
Business Email
Business Website
Business Type
Glass / Hardware / Import / Catering / .......
Main Products / Services
Other

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