Application

Type: *

Name: *

ID: *

Place of Birth:

Details:

Date of Birth:

Marital Status:

Place of Martyrdom / disappearance:

Date of Martyrdom / disappearance:

Martyrdom / disappearance conditions:

Source of Information:

Phone / Mobile: *

Address:

Email Address: *

Image:

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Attachment:

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Photos, documents, a statement about the incident, a statement from the Cross

Red Cross:

Civilian adminstration / military roler:

Others:

Red Cross:

Civilian adminstration / military roler:

Others:

Is there an agreement to raise the issue in the media?

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