hr CSL 0179842
CIVIL REGISTRY
(INDONESIAN NATIONAL)
EXCERPT OF
BIRTH CERTIFICATE
No. 3494/U
'$/1998.-
ENERAL:
It appears from the ~ —- registry of birth according to the State
Gazette of 1920 No, 751 in conjunction with 1927 No. 564 in UJUNG PANDANG, that in
UJUNG PANDANG, on the FIRST DAY OF SEPTEMBER one thousand nine hundred and
NINETY EIGHT —-
was born:
: SEPTIAN FAKHRULWAHID MASYKUR, M:
-first child-
a male child of married couple of : Ir, MAHMUDIN RACHMAN and Ir, RASTINA.—-——-
This excerpt corresponds with the state of affairs of this day. -
UJUNG PANDANG, on the TWENTY FIRST DAY OF
SEPTEMBER one thousand nine hundred and NINETY
EIGHT.
Head of Civil Registry Office of
UJUNG PANDANG MUNICIPALITY
signed and sealed
Drs. H. A. SYAHRAZAD GAZALING
NIP. 580 010 144.
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