| Street | 23 Stoffberg St | ||
| City/Town | Bela Bela Local Municipality | ||
| State/Province/Region | Limpopo | ||
| Zip/Postal Code | 0480 | ||
| Phone Number | 072 158 3933 | ||
| Country | South Africa |
| Full Name | Dr. Portia Smith | ||
| Gender | female | ||
| Birthday | 1980-06-14 | ||
| Social Security Number |
| Credit card brand | EnRoute | ||
| Credit card number | 2014609874583592 | ||
| Expire | 2028/3 | ||
| CVV | 529 |