Biodata

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BIODATA No. Kamar : ______________________________________ No. KTP : ______________________________________ Nama : ______________________________________ Tempat/Tanggal Lahir : ______________________________________ Alamat Sesuai Tanda Pengenal : ______________________________________ ______________________________________ Agama : ______________________________________ Suku : ______________________________________ No. Telp : ______________________________________ Universitas : ______________________________________ Fakultas/Jurusan : ______________________________________ Nama Orangtua Ayah : ______________________________________

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Transcript of Biodata

BIODATA

No. Kamar: ______________________________________No. KTP: ______________________________________Nama: ______________________________________Tempat/Tanggal Lahir: ______________________________________Alamat Sesuai Tanda Pengenal: ______________________________________ ______________________________________Agama: ______________________________________Suku: ______________________________________No. Telp: ______________________________________Universitas: ______________________________________Fakultas/Jurusan: ______________________________________

Nama Orangtua Ayah: ______________________________________ Ibu: ______________________________________Alamat: ______________________________________ ______________________________________No. Telp Ayah: ______________________________________ Ibu: ______________________________________

Nama Wali: ______________________________________Alamat: ______________________________________ ______________________________________No. Telp: ______________________________________

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*lampiran fotokopi KTP dan KTM untuk keperluan RT/RW setempat