Preview mode
Published
Copy responder link
Request edit access
PENDATAAN SAMPLING YANBUNG
Mengambil data dilapangan
Foto sambungan pengambilan kabel SR ? *
Add file
Required
Nama kWh meter pelanggan ? *
Terpasang SWC ? *
Required
Tanggal survei Sampling ? *
MM
/
DD
/
YYYY
Sambungan pengambilan Kabel SR ? *
Required
Foto Service Wedge Clamp (SWC) ? *
Captionless Image
Add file
Required
Foto kWh Meter ? *
Add file
Required
Foto Banggunan Rumah (Full) ? *
Add file
Required
No Meter atau Ide Pelanggan ? *
Alamat ? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report