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اقر انا / ........... - ديانة / مسلم / مسيحى - جنسية / مصرى - مهنة / صاحب 00000000000 - محل اقامــة / 000000000000000

بأنى قد وكلت عنى السيد / - ديانة – مـسلم / مسيحى -00000000000

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موضوع الدعوى 000000000000000 رقم 000006 00000000000000000000000000000

00000000000000000 .

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ملاحظة: اقر انا / ........... - ديانة / مسلم / مسيحى - جنسية / مصرى - مهنة / صاحب 00000000000 - محل اقامــة / 000000000000000

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