BIRTH CERTIFICATE
CSL
CIVIL
REGISTRATION
(INDONESIAN
CITIZEN)
EXCERPT
OF
BIRTH
CERTIFICATE
No.
3747/TP/1998
From
the................................................GENERAL...............................................registry
of births according to State Gazzette 1920 No. 751 Jo. 1927 No. 564 in Bandung
Civil Registry office states that
in.............................................Bandung...........................................................
On the twelve of February
nineteen ninety eight was born:
------------------------------------:SALMA
NABILA DWI PUTERI:----------------------------------
a daughter from the
husband and wife : Dwi Suharjito with Erni Yuniati. ------------------------
This
excerpt is in accord to the condition this day.
Bandung.................dated
on the third of August
two
thousands.--------------------------------------
INDONESIAN
IDENTITY CARD
PROVICE
OF BANTEN
CITY
OF TANGERANG
Register Number :
3617886920170000123
Name :
SALMA NABILA DWI PUTERI
Place, date of birth :
Bandung, 12 February 1998
Sex :
Female
Address :
Regency II Tangerang Blood
Type : O
RT/RW : 007/005
Village
Administrative Unit : Gelam Jaya
District
: Pasar
Kemis
Religion :
Islam
Marital Status :
Single
Occupation :
Student/University Student
Nationality :
Indonesia
Valid Thru :
Lifetime
 |
City of Tangerang
12-12-2017