Activity task 1

Name : Lestari puji rahayu

Age : I 20 years old

Sex : I am female

Address : I live in sidokapasan 3/1

City, state : Surabaya city

Phone : My number is 085101286913

Religion : I am islam

Marital status : I am single

Health insurance : I have no health insurance

Current occupation and title : college student

Next of kin : cousin and my parents

Reason for contact :for interview assessment

Date, time of contact : March,21,2020