Hotel Guest Registration Form

Name

Elsa Izdaryani

First Name Last Name

Email Phone Number

eizdaryani@gmail.com 0852-1283-2980

example@example.com Please enter a valid phone number.

Address
Prof. M.Yamin, Gg Gunung Kota Jalur 1 street

Street Address

Pontianak West Kalimantan

City State / Province

Booking Information

Check-in Date Check-out Date

20 May 2023 22 May 2023

Date Date

Pick-up Date Pick-up Time

20 May 2023 12:35 PM
Date Hour Minutes
Pick-up Location
Jenderal Ahmad Yani No. 91, Bansir Laut street.

Street Address

Pontianak City West Kalimantan

City State / Province

Room Type Smoking

Queen (Rp.2.991.230,00) Yes

#of Guests
4

Notes