DEPOK CITY
SERIAL
REGISTER NUMBER : 3267002903950001
Name : Rizkiana Amelia
Place/date
of birth : Jakarta,
March 29, 1995
Sex : Female
Address : Jl. Bunga No.17
Rt/rw : 001/08
Sub
District : Curug
Country : Cimanggis
Religion : Islam
Marital
status : Single
Occupation : Student
Nationality : Indonesia
Expiry : 29-03-2017
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