SD MUHAMMADIYAH TERPADU
RONOWIJAYAN SIMAN PONOROGO
Nama Guru
: ..................................................................................
NIS
: ..................................................................................
Kelas yang dibimbing
: ..................................................................................
Tahun Pelajaran / Semester
: ..................................................................................
No.
Jawaban
Ya Tidak A
Nilai
B C D
Keterangan
1.
Ponorogo, _______________
Kepala Sekolah,
_______________________
_________________
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