(INDONESIAN CITIZEN)
BANDUNG MUNICIPALITY
EXCERPT OF
BIRTH CERTIFICATE
No.6179/19...-
From
General Registration of Birth in accordance to state gazette of one thousand
nine hundred twenty number seven hundred fifty one conjunction with that of one
thousand nine hundred twenty seven number five hundred sixty four in Bandung,
it is found that in BANDUNG on the twentieth of June one thousand nine hundred
eighty four ,at five forty o’clock AM There was born :
“………………………”
The
daughter of Couple Married: ……….. and ………………………..
This
excerpt corresponds to the state of affairs at the moment of issue.
Bandung,
on the twenty sixth of June one thousand nine hundred eighty four.
Extraordinary
of Civil Registration
Sealed,
stamped and signed
………………………
unreadable
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