--·-- -- -~---- -

KAltfU I\K.1 1
DINAS TRANSMIGRASI PENDrDll<AN FORMAL
KADUPATEN PULAlJ TALIADlJ .... _ ...... Th _.,.. . . .. . .
JI M . 7ol1tf A/111 K1t.Tti//11/,11 IJUTot 97794 fJnatl Jl11a,1rratfl/llf(rm110 /tah1t1,tJ(mo// ,,.,,,
TIDAK TAMAT SD
SD I SEDERAJAT
KARTU TANDA Olll<.TI r ENOAFTARAN rENCARI KER.IA SLTP / SEDEIWAT
SMA I SEDERAJAT
Nomor ptndartaron p,ncarl kerJn ; .7?~.\~.L~.\.~ .. ~\.:..?..~\~.!.~.?.:?..~.~..................... ................ 011/DIIUSM
AKTA 11 ........ .. _......... TI1
Nomor lnduk kcpendudukan : ...~.?..~.~.~~~-~~.?.'!\]~.~.~\ ..................... ..............................
AKTA Ill . .................. . ········ ······ ·-····· Th ········· ......... .
, N•m• Lcmal,A11: .. .... ~~~-~\ .. ~~~\~~~'-~- S/PASCA/S.1/AKTA I V/D rv : ................................ .......... ..Th ...... ... ..... ... .
DOKTOR / S.11 / AKTA V .. ......... .. .. ................ - .... Th . ............... ..

~ ~ I\ l.s bhI
KETERAMPfLAN
p11t/T9I. Lahlr: ... \-:~Y.~.... ... . .... .. l. ............ - .................... - ........... ..................... - ...........- .... Th .............. ..... ..
2. ...................... .. .......... ...............- -. ..................... ....... TI1 .....................
l\ntln : (i:) Prla 2. Wonita
~ Dolum kawin
uJ 3. i, , - Th
[a]
• • • •••••••••••-•••.,• • •••••• • • •• • • " • • ••• •r-•••4 • •• • • -- "'• •'("/ •• ~•• ••••••• • • • •••••• .,••• • • - • • ••• • • ••• •• • - •
: I. Knwin 3. Jandn 4. Dudn 1 KorJg
:0:i hlam 2 Kolollk ri7
3 Protceuin -' f_:,;..:.~~ ~ IU l<erJ1
4. Hindu ~- Dudho ~
6. L11ln-l11ln L

I .,.
: .~~~.}~Nf.~f.\~.,.t~~...\&P.L.~~,.~~ ..1!.1:~!.':1i!r.?~~-......