CIVIL REGISTRY OFFICE
(INDONESIAN NATIONALITY)
EXCERPT OF BIRTH CERTIFICATE
No. 4137/1997
Based on general list concerning Birth by virtue of
Stbd. 1920 No. 751 Jo. 1927 No. 564 at TANGERANG, it was recorded that in
TANGERANG on the twenty second of June, Sunday, 07.30 WIB O’clock. In the year
nineteen ninety seven, a female child named TRESNA UTAMI was born as a THIRD
daughter to the married couple of HASRUL HASIBUAN and SRI HARTATI
This excerpts is in accordance with the current
conditions.
Tangerang, on date the eight of July year nineteen
ninety seven
Head of the Civil Registry Office of MUNICIPALITY OF
TANGERANG.
Drs. H.U. BACHRUDIN
NIP. 480043007.
IDENTITY
CARD REPUBLIK OF INDONESIA
SERIAL REGISTER NUMBER : 3603176206970XXX
NAME : TRESNA UTAMI
CITY / BIRTH OF DATE : TANGERANG, 22-06-1997
SEX : FEMALE BLOOD
TYPE: O
ADRESS : BINONG PERMAI BLOK B 12 NO 30
RT/RW
: 001/002
SUBDISTRICT : CURUG
DISTRICT
: TANGERANG
RELIGION : MOESLEM
MARITAL STATUS : HAVE NOT MARRIED
OCCUPATION : STUDENT
VALID TO : 30 – 12 – 2020
NATIONALITY : INDONESIA.
