KECAMATAN RANDUDONGKAL
DESA RANDUDONGKAL
DATA DAN ARSIP SURAT BAWAH NIKAH
No
Lapor Hari
Tanggal
Bulan
Tahun
II.
Calon Suami
1. Nama Lengkap dan alias
2. Bin
3. Tempat & Tgl Lahir
4. Warganegara
5. Agama
6. Pekerjaan
7. Tempat Tinggal
8. Nama Ibu
9. Status
:
:
:
:
:
:
:
:
:
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
Calon Istri
1. Nama Lengkap dan alias
2. Bin
3. Tempat & Tgl Lahir
4. Warganegara
5. Agama
6. Pekerjaan
7. Tempat Tinggal
8. Nama Ibu
9. Status
:
:
:
:
:
:
:
:
:
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
Lapor Hari
Tanggal
Bulan
Tahun
II.
Calon Suami
1. Nama Lengkap dan alias
2. Bin
3. Tempat & Tgl Lahir
4. Warganegara
5. Agama
6. Pekerjaan
7. Tempat Tinggal
8. Nama Ibu
9. Status
:
:
:
:
:
:
:
:
:
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
Calon Istri
1. Nama Lengkap dan alias
2. Bin
3. Tempat & Tgl Lahir
4. Warganegara
5. Agama
6. Pekerjaan
7. Tempat Tinggal
8. Nama Ibu
9. Status
:
:
:
:
:
:
:
:
:
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
Pembatu Pegawai Pencatat Nikah (P3N)
Randudongkal RT 01-19 & 63 (Kemiri Sewu)
(Muhammad Bilalludin)