ID CARD
DKI JAKARTA PROVINCE
SERIAL REGISTER NUMBER; 294981290481902
NAME: Marbuah
CITY/DATE OF BIRTH: Cilacap, feb 29th 1991
SEX: Male
ADDRESS: jl.berbagai bersama no 25 rt.04/rw.29 cilacap
RT/RW: rt 04/rw18
SUB DISTRICT: cilacap
COUNTRY: Indonesia
COUNTRY: Indonesia
REGENCY
RELIGION: Mixed religion
OCCUPATION: Penari salsa
EXPIRY: Unexpiry
MARITAL STATUS: Pernah menikah
SIGNATURE/FINGERSPRINT HEAD OF VILLAGE
DIMAS BAYUDIRA
4SA01
10609549
