Sh; AmagRRRY 274
2 tt Ha
Certificate for Completion of Registration to the ERFS
Sega
Ministry of Health, Labour and Welfare
KAMA, BRTHAMO ROCHA CORA
BRLUCKE. £5, CARR COREPRORI, COR
FROSLELRS SHBMNHVET.
“You are kindly requested to show this certificate to relevant
authorities of Japan in response to their request.
*You are also requested to show a copy of this certificate when you
apply for a visa at a Japanese overseas mission.
ARTE (HIME AL)
Name (Surname/Given name)
‘as shown in your passport
4288 (288)
Date of Birth (YYYYMMDD)
HRS MEME AL)
tas /esbort Number
‘as shown in your pass
i eM GRAM ELD
Nationality
shown in your pa:
weReR
Address of Hotel
or Other Accommodation
ERR
Name of Hotel or Other Accommodation
RABE
Name of Receiving Organization
SAREHOER
Address of Receiving Organization
BAWESORRE
Phone Number of
Rece
g Organization