NIK : 1112023112960001 NAMA : TEUKU A'LAISA LAM TEMPAT TANGGAL LAHIR : PADANG BAK JEUMPA 31-12-1996 ALAMAT: DUSUN PANG LIMA AHMAD GOLONGAN DARAH : B JENIS KELAMIN: LAKI-LAKI AGAMA : ISLAM STATUS PERKAWINAN : BELUM KAWIN PEKERJAAN : PELAJAR/MAHASISWA KEWARGANEGARAAN: WNI

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