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LAPORAN HASIL

KUNJINGAN RUMAH (Home Visit )

I. IDENTITAS SISWA
1. Nama : …………………………………………………………………….
2. Kelas/ No Absen : …………………………………………………………………….
3. Jurusan : …………………………………………………………………….
II. IDENTITAS ORANG TUA
1. Nama Orang Tua : …………………………………………………………………….
2. Alamat Rumah : …………………………………………………………………….
3. Telp/HP : …………………………………………………………………….
III. TUJUAN KUNJUNGAN RUMAH
………………………………………………………………………………………………..
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IV. HASIL WAWANCARA & OBSRVASI
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V. KESIMPULAN TINDAK LANJUT
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Mengetahui, Darma, ………………………………..


Kepala Sekolah Guru Home Visit
SMK IT Pelita Subana Darma

ANDRI ANDRIYANA, S.Sos ……………………………………….


NIY. 022016016011 ……………………………………….

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