| Street | Jalan Mohammad T. Haryono No.83 |
| City/Town | Balikpapan |
| State/Province/Region | Kalimantan Timur |
| Zip/Postal Code | 76113 |
| Phone Number | (0542) 874058 |
| Country | Indonesia |
| Latitude | -1.250833 |
| Longitude | 116.87018 |
| Full Name | Maimunah Salimah Lailasari |
| Gender | female |
| Birthday | 1997-01-05 |
| Social Security Number |
| Credit card brand | Voyager |
| Credit card number | 8699951308117640 |
| Expire | 2030/9 |
| CVV | 015 |