City/ Date of birth : Jakarta, 04-02-1992
Sex : Female
Blood Type : -
Address : Jl. cibubur 2 bulak ringin 4
number.58
Country/Village : Cibubur
Sub-district : Ciracas
Religion : Islam
Matrial status : Unmarried
Occupation : Entrepreneur
Nationality : Indonesia
Expiry : 04-02-2016
