EN | ID
REGISTRASI QANTAS
QANTAS REGISTRATION
Kode Verifikasi
Verification Code
(Case Sensitive)
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Nama
Name
No. KTP
(Hanya untuk WNI)
KTP Number
(for Indonesian Only)
No. Passport
Passport Number
Alamat tinggal selama di Indonesia, selain Bali
(Alamat lengkap atau nama Hotel)
Address of stay while in Indonesia, other than Bali
(Full address or Hotel name)
Alamat menginap selama di Bali
(Alamat lengkap atau nama Hotel)
Address of stay while in Bali
(Full address or Hotel name)
Jenis Kelamin
Sex
Laki-Laki
Male
Perempuan
Female
Tanggal Lahir
Date of Birth
Email
Ulangi Email
Retype Email
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No. Telepon
(kode negara & nomer, contoh 6281123456789)
Phone Number
(country code & phone number, ie 628123456789)
Pemeriksaan
Examination
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Cabang
Branch
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Lokasi
Maps
Rencana Tanggal Pengambilan Swap/Sample
Arrival date for sampling
Daftar
Register
Proses Pendaftaran
Registration
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Are you sure to proccess?
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Registration
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