- BIRTH CERTIFICATE -
CIVIL REGISTRATION
(CITIZEN OF INDONESIA)
Excerpt of
BIRTH CERTIFICATE
No. 258/ist/91
By Virtue of Birth Certificate Number stbld 1920-751 Jo 1927-564 In accordance with state government gazette in Bogor, that in JAKARTA on date thirteenth of January on the year of Nineteen Ninety-one had been born a daughter, named : IRA KURNIATI Legitimate child of: spouse couple ......... and ........
Based on the decision letter from the head of district in Bogor Number.474.1/130/kpts/Huk/91 on October 14, 1991.
This excerpt issued in Bogor,
On date fourteen of October Nineteen ninety one.
Head of the Civil Registration Office
Bogor Regency
Dra. H. Penny Kurniasih
________________________
NIP.480.036.012.
- THE IDENTITY CARD -
Province : East Java
City : Depok
Serial Register Number : 3276055301910001
Name : IRA KURNIATI
Place / Date of Birth : Jakarta / January 13, 1991
Sex : Female
Blood Type : -
Address :
Sub district / Village : ABADIJAYA
County : SUKMAJAYA
Marital Status : Single
Religion : Islam
Occupation : Student of University
Valid Until : 13-01-2016
Nationality : Indonesian
___________________
Sign / Thumb Print
DEPOK CITY
18-07-2011
HEAD OF DEPARTMENT RECORDS AND CIVILIAN POPULATION
Stamp and Sign
Drs. MULYAMTO
_________________________
NIP : 196009201988031003
- MEMBER CARD -
UG Smart Card
ENGLISH LITERATURE
IRA KURNIATI
10608059
1. The identity card is valid for card holder is on duty and has status as a student at the Gunadarma University.
2. These cards are the property of Bank DKI to be recovered or refunded if requested by the GUNADARMA UNIVERSITY and or Bank DKI.
3. These cards are not transferable in any way.
4. Use of this card is governed and subject to applicable regulations.
5. If found this card please return to: Bureau of Public Administration (BAU) Gunadarma University, Jl. Margonda Raya 100, 16424 Depok Pondok Cina, phone. (021) 78881112 Ext. 206 or nearest Bank DKI, phone. (021) 2354 5555
- MEMBER CARD -
Participant’s card
ASKES
Health Insurance Specialist
0000208429918
IRA KURNIATI
13/01/1991
President Director
Dr. I Gede Subawa, M. Kes
Always ask for DPHO Drug
1. Participants card must be brought during treatment.
2. If the card is misused, will be penalized.
3. If there is a change of data or loss of card, immediately report to the office of PT Askes (Limited) around.
Toll Free 0800 11 27537 – 0800 11 ASKES
Call Center 500400
www.ptaskes.com
- DIPLOMA -
NATIONAL EDUCATION DEPARTMENT
REPUBLIC OF INDONESIA
DIPLOMA
SENIOR HIGH SCHOOL
STUDY PROGRAM : SOCIAL SCIENCE
ACADEMIC YEAR 2007/2008
The undersigned, Head of "Yaspen Tugu Ibu 1 Depok" Senior High School states that :
Name : IRA KURNIATI
Place / date of birth : Jakarta / January 13, 1991
Name of Parent :
Previous School : Yaspen Tugu Ibu 1 Depok Senior High School
Register Number : 050610 144
PASSED
from the education units based on the results of National Examination and School Examination and has fulfilled all of the criteria in accordance with the legislation.
Depok, June 14 2008
Headmaster,
Hj. Sri Partiwi, BA
____________________
NIP : -
