DINAS PENDIDIKAN
SMK NEGERI 1 KEBONSARI
PEMERINTAH KABUPATEN M
DINAS PENDIDIKAN
SMK NEGERI 1 KEBONSA
SURAT KETERANGAN
NAMA SISWA
KELAS
KEPERLUAN
ALASAN
NAMA SISWA
KELAS
KEPERLUAN
ALASAN
:
:
:
:
WAKTU
: Pukul
WAKTU
:
:
:
:
:
:
............................................................
............................................................
Ijin Masuk/Keluar/Pulang* jam ke .......
............................................................
............................................................
Pukul ................ sampai .................
...............................
...............................
Ijin Masuk/Keluar/Pu
...............................
Mengetahui
Guru Piket
Kebonsari, ..................
Guru Mapel
Mengetahui
Guru Piket
........................
NIP.
...........................
NIP.
........................
NIP.
KETERANGAN IJIN
.....................................................
.....................................................
Masuk/Keluar/Pulang* jam ke .......
.....................................................
................ sampai
.................
Kebonsari, ..................
Guru Mapel
...........................
NIP.