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Name
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Yamamoto Hirohisa
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Date of Birth: 1966-2-14
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Adress
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2-11-1 Tianshen, Ikeda City, Osaka
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Latest replacement date
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2014-2-4 11840
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driver's license
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Photo
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Valid Period:2019-3-14
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Driving conditions(good): glassess, midsize cars, midsize cars only (8 Tons)
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No.
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638500810950
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Wheelers, car, original vehicle
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1985-2-20
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Osaka Public Security Commission (seal)
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Others
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1985-9-24
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2nd class
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1989-0-0
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Remarks--------------------------------------------------------------------------------------
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Statement on the provision of internal organs of the human body (voluntary)
If yes, draw a circle in the 1-3 option 1. I hereby donate internal organs after brain death and cardiac arrest 2. I hereby donate internal organs only after my heart stopped 3. I do not donate internal organs 〈Put a fork in the following that you do not want to donate after you choose 1 or 2 above〉 (heart, lungs, liver, kidney, pancreas, small intestine, eyeball ) 【special record】(signature) (Date) |