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Municipal and government · Form

Sample Form: ثبت‌نام اسکان اضطراری

در حوادث: خانوار، نیازهای ویژه، محل فعلی و شماره تماس — برای مدیریت بحران.

6 questions · Free up to 50 responses a month

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About this template

“ثبت‌نام اسکان اضطراری” has 6 questions; 5 are required and 1 optional. Question types: Short text (1), Mobile number (1), National ID (1), Quantity / order (1), Multiple choice (1), Map location (1). 4 ready-made options across 1 choice questions, all editable in the online version.

In the online version of this template

  • National IDs are checked instantly with the check-digit algorithm.
  • Mobile numbers are validated against the Iranian number format.
Related:Online form builderIranian national ID validator

Questions in this template

  1. 1.

    نام و نام خانوادگی *

    (Short text)
  2. 2.

    شماره موبایل *

    (Mobile number)
  3. 3.

    کد ملی سرپرست *

    (National ID)
  4. 4.

    تعداد افراد *

    (Quantity / order)
  5. 5.

    نیازهای ویژه

    (Multiple choice)
    • سالمند
    • نوزاد
    • معلولیت
    • بیمار نیازمند دارو
  6. 6.

    محل فعلی *

    (Map location)

Printable or online?

Printable version (Word & PDF)

  • For filling in on paper, signing and filing by hand
  • Edit the Word file any way you like
  • Collecting and typing up the answers is up to you
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Online version on Porsino

  • Answers are collected and organised automatically — no retyping
  • National ID, mobile number and dates are validated instantly
  • Ready-made reports and charts, plus Excel export in one click
  • Share a link or QR code — it works on mobile too
Build the online version for free

How do I use this template?

  1. Sign up for Porsino for free; no bank card needed.
  2. In the panel, open “Templates” and choose “ثبت‌نام اسکان اضطراری”.
  3. Change the questions as you like, publish the form and send the link.

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