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FORM PENDAFTARAN
Mohon mengisi seluruh kolom yang kami sediakan dan pastikan data yang dimasukan sudah sesuai dan benar.
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EMAIL
*
Aktif
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NAMA LENGKAP
*
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NO TELFON
*
Yang terkoneksi dengan WhatsApp
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NIM (Mahasiswa) /NIK (Nomor Induk Karyawan)
*
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JENIS KEANGGOTAAN
*
DOSEN
D3 KEBIDANAN
S1 ADMINISTRASI RUMAH SAKIT
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