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Hä vµ
tªn:..................................................................................................................................................
...............................
Ngµy, th¸ng, n¨m, sinh:..........
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§Þa chØ (theo Hé khÈu):...
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Lµ sinh viªn n¨m thø:...............Líp:...................Kho¸:.........(Tõ n¨m:....................®Õn
n¨m....................)
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quy...............................................................................................................................
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