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YAYASAN AR RAUDHAH ILMI SALAMAH

SMKS PERBANKAN YARIS DURI


NO:211/KPTS-DISDIK/VIII/2016
NPSN : 69952586
email: smkperbankan_yaris@yahoo.com
Jalan Asrama Tribrata Pematang Pudu Duri. Telp. 08127500663/085264749887

HASIL TES SISWA


SMKS PERBANKAN YARIS DURI RIAU

NAMA : ........................................................................
TTL : ........................................................................
ALAMAT : ........................................................................
NAMA IBU : ........................................................................
NAMA AYAH : ........................................................................

NO URAIAN HASIL KETERANGAN


1. BERAT BADAN
2. TINGGI BADAN
3. TENSI
4. NADI
5. PERNAPASAN
6. SUHU
7. GOLONGAN DARAH
8. MATA
- MIOPI
- BUTA WARNA
9. KESEHATAN
- PENYAKIT YANG DI
DERITA
- ALERGI

HASIL PSIKOTEST
- WAWANCARA : __________________________________________________
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- MENGAJI (RELIGI) : __________________________________________________
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- KEBERSIHAN : __________________________________________________
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Duri, …….…………….20…
SMKS Perbankan Yaris
Mengetahui:
Calon Peserta Didik Panitia PPDB

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