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Validasi Data pelaku Perjalanan - KKP Ambon
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Lokasi
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Pelabuhan Yos Sudarso Ambon
Pelabuhan Slamet Riyadi Ambon
Pelabuhan Galala
Pelabuhan Siwabessy
Wilker Tulehu
Wilker Namlea
Wilker Tual
Wilker Saumlaki
Wilker Dobo
Wilker Banda
Wilker Bula
Wilker MOA
Nama Lengkap
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NIK
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Your answer
Usia
Your answer
Alamat
Your answer
No HP
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Tanggal Keberangkatan
MM
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DD
/
YYYY
Tujuan Keberangkatan
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Nama Kapal
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Jenis Pemeriksaan
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Rapid Test
Swab Test
Surat Keterangan Sehat
Hasil Rapid/Swab Test/Surat Keterangan Sehat
Reaktif/Positif
Non Reaktif/Negatif
Sehat Bebas Gejala ( khusus surat ket. sehat)
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Tanggal Pemeriksaan Surat
MM
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DD
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YYYY
Nama Petugas Validasi
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