RUANGAN,...............................................
TGL,...............................................
NO NAMA MAHASISWA
Senen Selasa Rabu Kamis Jumat Sabtu Ming
gu
1
2
3
4
5
6
7
Jakarta,..............................20....
Mengetahui
CI / Kepala Ruangan
(.................................................)
Jakarta,..............................20....
Mengetahui
CI / Kepala Ruangan
(.................................................)