FORMULIR PEMBERKASAN BIDAN PTT KAB. SRAGEN TAHUN 2019
NO URUT (no absen pemberkasan) *
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NAMA (TANPA GELAR) *
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GELAR DEPAN
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GELAR BELAKANG
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TEMPAT LAHIR *
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TANGGAL LAHIR *
MM
/
DD
/
YYYY
JENIS KELAMIN *
AGAMA *
EMAIL *
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NO. KTP *
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ALAMAT *
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NO. TELP *
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STATUS *
JENJANG PENDIDIKAN TERAKHIR *
RENCANA PENEMPATAN
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NO AKTE KELAHIRAN *
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NO. NPWP
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TANGGAL NPWP (tanggal terdaftar)(bagi yang sudah memiliki)
MM
/
DD
/
YYYY
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