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ABORADZE EBUSUA

OF

MUMFORD
WELFARE MEMBERSHIP CARD

Card No…………….

Name: ………………….…………..……….…

Dampon: ……………………………….…….…

Ebusuapanyin, Kow Otumko:


……………………………………….……….….
CONTRIBUTION CONTRIBUTION
Date of Date of
Name of Deceased Amount Sign Name of Deceased Amount Sign
payment payment

TOTAL AMOUNT TOTAL AMOUNT

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