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Nongsa Point Marina
Batam Island ,Indonesia

Berth Request Form


Full Name :
NIRC / Passport Number :
Nationality :
Date of Birth :
Residencial Address :
Company Name :
Company Address :
Registration Number :
Country of Incorporation :
Name of Vessel :
Arrival Date :
L.O.A (feet) :
Last Port of Call :
Gross Tonnage :
Departure Date :
Flag / Nationality :
Next Destination :
Draft in Meter :

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