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Formulir Pendaftaran Lomba Batik Rumah Sakit Panti Rapih
Silakan mengisi formulir dibawah ini, untuk mengikuti Lomba Desain Batik dalam rangka HUT ke 90 Rumah Sakit Panti Rapih Yogyakarta.
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Nama Lengkap
*
Name
Your answer
Tanggal Lahir
*
Birth of Date
MM
/
DD
/
YYYY
Alamat
*
Your address
Your answer
Nomor Handphone
*
phone number
Your answer
Nomor Whatsapp
*
Whatsapp Number
Your answer
Pekerjaan/ Sekolah
*
Occupation/ College
Your answer
Narasi Makna Desain Batik
*
Naration about your design
Your answer
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