HARI :
TANGGAL :
TEMPAT :
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
NO NAMA / NIP PANGKAT / GOL JABATAN DALAM TIM TANDA TANGAN
19 ....................................................
Nip
20 ....................................................
Nip
21 ....................................................
Nip
22 ....................................................
Nip
23 ....................................................
Nip
24 ....................................................
Nip
25 ....................................................
Nip
26 ....................................................
Nip
27 ....................................................
Nip
28 ....................................................
Nip
29 ....................................................
Nip
30 ....................................................
Nip
31 ....................................................
Nip
32 ....................................................
Nip
33 ....................................................
Nip
34 ....................................................
Nip
35 ....................................................
Nip
36 ....................................................
Nip
NO NAMA / NIP PANGKAT / GOL JABATAN DALAM TIM TANDA TANGAN
37 ....................................................
Nip
38 ....................................................
Nip
39 ....................................................
Nip
40 ....................................................
Nip
41 ....................................................
Nip
42 ....................................................
Nip
43 ....................................................
Nip
44 ....................................................
Nip
45 ....................................................
Nip
46 ....................................................
Nip
47 ....................................................
Nip
48 ....................................................
Nip
49 ....................................................
Nip
50 ....................................................
Nip
51 ....................................................
Nip
52 ....................................................
Nip
53 ....................................................
Nip
54 ....................................................
Nip
NO NAMA / NIP PANGKAT / GOL JABATAN DALAM TIM TANDA TANGAN
55
56 ....................................................
Nip
57 ....................................................
Nip
58 ....................................................
Nip
59 ....................................................
Nip
60 ....................................................
Nip
61 ....................................................
Nip
62 ....................................................
Nip
63 ....................................................
Nip
64 ....................................................
Nip
65 ....................................................
Nip
66 ....................................................
Nip
67 ....................................................
Nip
68 ....................................................
Nip
69 ....................................................
Nip
70 ....................................................
Nip
71 ....................................................
Nip
72 ....................................................
Nip
73
74
75
76
77
78
79
80
Yang menyerahkan :
2
3
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
27
74
75
26
27
28
29