Uchtepa region

Ўкувчининг оила аъзолари __________нафардан иборат.
Отаси: _______________________________________________________________________
(Ф.И.Ш. туган йили, яшаш манзили)
Отасининг иш жойи ва лавозими, телефони:________________________________________
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Онаси: _______________________________________________________________________
(Ф.И.Ш. туган йили, яшаш манзили)
Онасининг иш жойи ва лавозими, телефони:________________________________________
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Фарзандлари: ________________________________________________________________
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Оила _______________ хонали уйда истикомат килади
Санитар холати: ______________________________________________________________
Оиланинг ижтимоий холати: ___________________________________________________
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Оилада ўзаро муносабат: ______________________________________________________
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Хулоса:______________________________________________________________________
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“_________________” МФЙ раиси: __________ ________________________

(имзо) ( Ф.И.Ш.)