| Street | Jl. Pulau Sayang No 24 | ||
| City/Town | Denpasar | ||
| State/Province/Region | Bali | ||
| Zip/Postal Code | 80111 | ||
| Phone Number | (0361) 8422441 | ||
| Country | Indonesia |
| Full Name | Laras Laksmiwati S.Gz | ||
| Gender | female | ||
| Birthday | 1999-07-28 | ||
| Social Security Number |
| Credit card brand | American Express | ||
| Credit card number | 349684631900686 | ||
| Expire | 2028/1 | ||
| CVV | 078 |