FORM PENDAFTARAN SISWA DIDIK BARU SMP NEGERI 4 ADIWERNA
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RUANG PENDAFTARAN
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NO. PENDAFTARAN
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NAMA CALON PESERTA DIDIK BARU
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NISN
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TEMPAT LAHIR
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TANGGAL LAHIR
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MM
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DD
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YYYY
AGAMA
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NAMA AYAH
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NAMA IBU
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AREA ZONA
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KEC. ADIWERNA
KEC. DUKUHTURI
KEC. TALANG
LUAR ZONA
JUMLAH NILAI SKHUNS
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JUMLAH BONUS PRESTASI
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ASAL SEKOLAH
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TAHUN LULUS SD
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