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Data Calon Santri MA
Ponpes Miftahussalam Banyumas TP. 2019/2020
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NISN
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Nomor Kartu Indonesia Pintar (KIP) jika ada
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Nama Santri
*
Nama ditulis lengkap tanpa singkatan dan menggunakan huruf KAPITAL
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Jenis Kelamin
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Laki-laki
Perempuan
Tempat Lahir
*
Kota
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Tanggal Lahir
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Bulan/tanggal/tahun
MM
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DD
/
YYYY
Alamat (Jalan / RT-RW)
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Desa/Kelurahan
*
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Kecamatan
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Kabupaten
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Provinsi
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Nama Ayah
*
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Nama Ibu
*
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Penghasilan orangtua
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Telp/HP Orangtua/Wali
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Asal Sekolah
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