Wife's OccupationOtherHusband to beDate RegisteredFull NameGiven Name: ToruYearWe accidentally kissedHusband and Wife's OccupationsPhoto or Portrait(Pronunciation)--rth Date
Should be birth date, but it's blocked.KazamaToruFamily Name: KazamaGiven NameMonthDayMonthwith
startYearHusband's OccupationWifeWifeMarriage RegistrationFamily NameSubmitters' Signatures and SealsHusband