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Formulir tanpa judul
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nama lengkap
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tuliskan nama anda menggunak kaidah
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nomer induk
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masuk nomer induk anda
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kelas
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XIIPS1
XIIPS2
XIIPS3
XIIPS4
XIIAP1
XIIAP2
XIIAP3
XIIAP4
Jenis kelamin
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laki-laki
perempuan
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tempat lahir
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tanggal lahir
MM
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DD
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YYYY
agama
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islam
katholik
protestan
hindu
budha
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alamat
tuliskan alamat lengkap anda
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