BIRTH CERTIFICATE
CIVIL REGISTRATION
JAKARTA
EXCERPT
BIRTH CERTIFICATE
No. 196/1991
From GENERAL registration for Indonesian Citizen births pursuant to the State Gazette in Jakarta, that in Jakarta om date twenty one of December nine teen and ninety one was born : …........................................................................... : AYU MAWARDIKA : …........................................................................ son of married couple : ….......... SUPARMIN dan YANTI MALA....................
This excerpt conforms yo the condition on this day Jakarta,
dated first of January.......
nine teen and ninety one,
Head of Civil Registration Office
KIKI PURNAMASARI
NIP : …..........................
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