[Translator’s notes appear in square brackets]

[Personal information has been redacted.]



Islamic Republic of Iran

Decision of the Personnel Office

In the Name of God

Form: 32 Ayn (52/4), Administrative and Recruitment Affairs Organization of Iran

1- Ministry/Institution: [Ministry of] Health

2- Employee number: [redacted]

3- Given name: Mrs. Molouk

4- Surname: Sadeghi Ardekani

5- Father's name: Abdol-Maid

6- Birth certificate number and place of issue: Birth certificate number: [redacted]; Issue in: City of [redacted]

7- Place of birth: Mashhad

8- Date of birth: Day 11, Month 6, Year 1328 [2 September 1949]

9- Highest level of education and field: Highest level: Elementary - Grade five, two years of nurse practitioner training

10- Title of permanent position: Nurse Practitioner, number [redacted]

11- Guild: Health and Treatment, Rank: Nurse Practitioner, Level: 2

12- Group: 5

13- Base: 5

14- Organizational Unit: East Region, Shahid Ayatollah Ashrafi Isfahani Hospital

15- Location of service: Tehran, Province/Region: Tehran

16- Reference: Date---- Number----

17- Type of Decision: Termination of Service

18- Details of decision: Considering your direct admission on 27/3/1363 [17 June 1984] to [adherence to] the Baha'i sect, in light of circular number 75601-10/10/1359 [31 December 1980] to the Ministries, and correspondence number 1/2/1/12237-27/3/1363 [17 June 1984], from the date of enforcement of this decision your services will be terminated in this hospital, and from the said date onward you shall have no position in the Ministry of Health.

19- Salaries, benefits, and bonuses

20- Salaries, benefits, and bonuses indicated in this decision, for the total sum of (in letters) ---- rial are payable subsequent to statutory deductions from credit----, section----, article----

21- Date of enforcement of decision: 30/3/1363 [20 June 1984]

22- Date of issuance and decision number: Date: 3/4/1963 [24 June 1984], Number 1691

23- Given name and surname, and position of the Officer in Charge: Dr. Sayyid Kazem Taqavi

Title of permanent organizational position: Head of Shahid Ayatollah Ashrafi Isfahani Hospital

Signature: [signature]

Copy: Employee