Name :
Putri Dyah Utami
NPM :
10608091
Class :
4 SA 01
A.
Identity Card
DKI
JAKARTA PROVINCE
|
Name :
Indah Kurniasari
Date and Place of Birth : Jakarta, March, 20 1992
Sex :
Female
Blood Type : B
Address : Jl. Merapi G2 No.7 Perum Jati
Rangon
RT/ RW :
004/ 003
Village :
Pondok Rangon
Sub-district :
Cilangkap
Regency/ City :
East Jakarta
Religion : Islam Marital
Status : Single
Occupation : Official employee
Nationality : Indonesia
Valid Until : March, 20 2017
Jakarta,
March, 20 2012
Head
of Sub-district
Stamp
and Signature
M.
Iqbal Rahman, SE
Signature/ Thumb Print of the ID
holder NIP.
09125473879016427
A.
Driver License
THE
PUBLIC OF INDONESIAN STATE POLICE
Driving License A
METRO JAYA
Female
Name :
Indah Kurniasari
Address :
Jl. Merapi G2 No.7 Perum Jati Rangon, Pondok Rangon,
JakartaTimur
|
|
Height :
168 cm
Occupation :
Official employee
Driving License
Serial Number :
123456789011
Expiry Date :
March, 20 2017
Jakarta,
February, 15 2012
The
Head of City Sub Regional Police
Stamp
and Signature Signature
Drs.
Lukman Hasan. MM
Adjutant
of City Teritorial Police, NRP. 65492043
B. Birth Certificate
C I V I L R E G I S T R A T I O N
CITIZEN : INDONESIA
JAKARTA
E X C E R P T
B I R T H C E R T I F I C A T E
No. 2247/JS/1994
From
the list of ------------------------------------- G e n e r a l
-------------------------------------- of birth by Stbld. 1920 No.751
Yo. 1927 No. 564_________________________
in Jakarta, that in Jakarta on -------------------------------- March, twenty
----------------------------------- nineteen ---------------------------------------
ninety two ---------------------------------------- was born :
--------------------------------------------------- “INDAH KURNIASARI”
-----------------------------------------the daughter of the married couple :
RESTU MULYANA and ----------------------------- SULISTYAWATI.
-----------------------------------------------------------------------------------------------------
--==oo00oo==--
This
excerpt is apt to the situation today. Jakarta, March, twenty -------------------------------Nineteen
ninety two.
Particular
Employee of Civil Registration, Head of Civil Registration Office East Jakarta,
Stamp
and Signature
Rifqi
Ramadhan NIP. 00100357614
Witness to declare the signature above
of Rifqi Ramadhan the Head of Civil
Registration Office, Particular Employee
of Civil Registration in Jakarta, East Jakarta.
|
Stamp and Signature Didik Sudarman, SH
NIP.
040026730897
A.
Tax Payer Registration Number Card
|
Directorate General of Tax
Main Number of Duty Tax : 14.346.002.4-607.000
INDAH KURNIASARI
Jl. Merapi G2 No.7 Perum Jati Rangon,
Pondok
Rangon, JakartaTimur
Registered : 26/09/2011
Pay off your
Taxes, Watch the Users
B. Medical Card
General and
Childbirth Clinic
SETIA RUMANDA
Jl. Raya
Lapangan Tembak Kelapa Dua Wetan No. 62 Jakarta Timur
Telp.
8705159
PATIENT
CARD
No. 390 006 03
The Name of Patient : Indah
Kurniasari
Sex : Female
Address of Patient : Jl.
Merapi G2 No.7 Perum Jati Rangon, Pondok Rangon,
JakartaTimur
Keep this card and bring it anytime
you need to come to the clinic
