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Survey Kepuasan MasyarakatÂ
Data Pemohon
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Pekerjaan
TNI/POLRI/PNS
Pegawai Swasta
Wiraswasta/Usahawan
Pelajar/Mahasiswa
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Jenis Kelamin
Laki-laki
Perempuan
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Tanggal kunjungan
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Pendidikan
SD
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DIPLOMA
SARJANA (S1)
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Nama
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Jenis Layanan Yang DIterima
Nomor Induk Berusaha (NIB)
Penanganan Pengaduan
Konsultasi
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Email
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Alamat
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