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REGISTRATION FORM

CATEGORY : 12 KM

NO REGISTRATION : M01251a5e
Registration Date : July 13, 2022

NAME SofiaMikhaila Anantyo


DATE OF BIRTH 12/08/2014
ID NUMBER C9773360
ADDRESS Jl Anggraini Raya no 11 Semarang
Semarang
Jawa Tengah
Indonesia
MOBILE PHONE +6285293699594
EMAIL ADDRESS sofiamikhaila0812@gmail.com

Congratulations on your successful registration in


MESASTILA100 - 2022

Mesastila100
Phone : (0298) 596333
Email : mesastila100@gmail.com

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