[Translator’s notes appear in square brackets]

[Personal information has been redacted.]



Date: 28 Farvardin 1363 [17 April 1984]

Number: 3372

(G Series)


Islamic Republic of Iran

Tehran Municipal Council

Behesht-e Zahra


The sum for burial recorded in the table below was received from Mr. Rahimian and was deposited in account number 91002 of the Cemeteries Organisation of Tehran, Behesht-e Zahra Bank Melli


Sum received: 9000

Account number [illegible]

Date: 28 Farvardin [17 April]

Bank Melli Iran

Behesht-e Zahra Kiosk

Warning: Receipts with an incomplete table by [illegible] are not valid


[Handwritten note, signature and stamp at the top of the page]


[Handwritten note, number and date at the bottom of the page]

Execution number [without any identity details]

Registry of Birth


18 Farvardin 1363 [17 April 1984]