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DATA PENDUDUK SEMENTARA PER-KELURAHAN
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DATA PENDUDUK SEMENTARA KELURAHAN
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BASIRIH SELATAN
KELAYAN BARAT
KELAYAN DALAM
KELAYAN TENGAH
KELAYAN TIMUR
KELAYAN SELATAN
MANTUIL
MURUNG RAYA
PEKAUMAN
PEMURUS BARU
PEMURUS DALAM
TANJUNG PAGAR
TAHUN
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NAMA PENGISI
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JABATAN PENGISI
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NAMA LENGKAP
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JENIS KELAMIN
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L
P
NOMOR IDENTITAS / TANDA PENGENAL
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TEMPAT & TANGGAL LAHIR
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contoh : BANJARMASIN, 16 SEPTEMBER 1975
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PEKERJAAN
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contoh : SESUAIKAN DENGAN KTP/KK
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KEWARGANEGARAAN
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WNI
WNA
KETURUNAN
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contoh : banjar, bugis, jawa, dll
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DATANG DARI
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TEMPAT ASAL TAMU
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MAKSUD KEDATANGAN
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contoh : BERTAMU, ACARA PERKWINAN, SELAMATAN DLL
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NAMA & ALAMAT YANG DI DATANGI
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contoh : AMINUDDIN, RT 01 RW O2 NO.46
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DATANG TANGGAL
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PERGI TANGGAL
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KET (-)
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