| ‘è–¼ | Ц‚¢‰Æ‚©‚ç‚Ì•¶Šw | 
| “Ç‚Ý | ƒTƒ€ƒCƒCƒGƒJƒ‰ƒmƒuƒ“ƒKƒN | 
| ‚g‚s‚l‚k | 97092 | 
| Œ´‘è^‰ü‘è^•›‘è^”õl | @ | 
| –{‚̑薼 | w’©“úV•·•ÊW‚o‚q”Å‚P‚X‚V‚O^‚O‚Q^‚O‚Sx | 
| o”ÅŽÐ | ’©“úV•·ŽÐ | 
| –{‚̃TƒCƒY | @ | 
| ‰”Å•w“ü”ÅD”NŒŽ“ú | @ | 
| ‰¿Ši | –¢w“ü | 
| ”•\ŽGŽ^”•\êŠ | w’©“úV•·•ÊW‚o‚q”Å‚P‚X‚V‚O^‚O‚Q^‚O‚Sx | 
| ì•i”•\@”NŒŽ“ú | ‚P‚X‚V‚O”N‚QŒŽ‚S“ú | 
| ƒR[ƒhNo | 19700204-00000000 | 
| ‘‚«o‚µ | @ | 
| ì•i•ª—Þ | @ | 
| ŒŸõƒL[ƒ[ƒh | @ |