No. Reg
: 13050514070
Jurusan
Prodi
: ................................................................................................................
No. Reg
: ................................................................................................................
Jurusan
: ................................................................................................................
Prodi
: ................................................................................................................
Judul Skripsi
: ................................................................................................................
................................................................................................................
................................................................................................................
................................................................................................................
................................................................................................................
................................................................................................................
: ................................................................................................................
Surabaya, ..............................................
Mengetahui,
Dosen Pembimbing/Penguji
............................................................
............................................................
NIP. ....................................................
NIM. ....................................................