NSSF NO:
NSSF
                                                            Growln1You. For Good
           PICHA
                                       MEMBERSHIP CARD
                                        ( KADI YA UANACHAMA )
 FULL NAMES: ................................................... .
 ....................................................................................
 ID/PP/NO: ......................................... .............. .
 DATE OF BIRTH ...... .• ......•..........1, ................ .
 DISTRICT: ...................................................·-······
 NSSF OFFICE: ................................................ ... .
 DATE OF ISSUE: .-.·-·········-·································
 EMPLOYER'S No: ...... ........ .•.........................•
 MEMBER SIGNATURE: .............•........•..••••••....
                  SF/R&C/REG/DF/003A
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     Astatement ofacrount can be
    obtaned at arry NSSF office _
   Sg,atLre ..... ............................................... .
   Rubber stanp
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