FM-UHT-PBM-06-01/R0

DATA WISUDAWAN

NAMA LENGKAP : ERVINA STYA INSANUL HIKMAH ........................................................

JENIS KELAMIN : PEREMPUAN .......................................................................................

TEMPAT, TANGGAL LAHIR : SIDOARJO, 27 JULI 1995 ......................................................................

NIM (sama dengan di PDUHT) : 20140400066 ......................................................................................

FAKULTAS : KEDOKTERAN ......................................................................................

JURUSAN : PENDIDIKAN DOKTER ..........................................................................

PROGRAM STUDI : PENDIDIKAN DOKTER ..........................................................................

TANGGAL LULUS : 01 FEBRUARI 2018 ..............................................................................

INDEKS PRESTASI (IP) : ............................................................................................................

JUDUL T.A./SKRIPSI/THESIS : HUBUNGAN ANTARA KENAIKAN BERAT BADAN IBU SELAMA HAMIL
DENGAN KEJADIAN KETUBAN PECAH DINI DI RUMKITAL DR.
RAMELAN SURABAYA PERIODE JANUARI-DESEMBER 2016 .................

ASAL SLTA : SMA HANG TUAH 2 SIDOARJO ...........................................................

ALAMAT SLTA : JL. KRI RATULANGI NO. 01- SAWOTRATAP-GEDANGAN-SIDOARJO ..

ALAMAT ASAL / DAERAH : SIDOARJO ............................................................................................

ALAMAT DI SURABAYA : - ...........................................................................................................

EMAIL : ervina.stya@gmail.com ......................................................................

NO. TELP / HP : 081358006678 ...................................................................................

STATUS : BELUM MENIKAH ................................................................................

NAMA AYAH : LILIS STYOBUDY SYAM SHODIQ ..........................................................

NAMA IBU : SITI ZUMAROH ....................................................................................

PEKERJAAN OTANG TUA : WIRASWASTA......................................................................................

ALAMAT ORANG TUA : PERUM GRIYA CANDRAMAS BLOK FA-04 KEC. SEDATI KAB. SIDOARJO

Nama tersebut di atas telah Surabaya, 26 FEBRUARI 2018

memenuhi persyaratan wisuda Wisudawan
Kepala TU

…………………………………………………………………. ERVINA STYA INSANUL HIKMAH.

NIK. ………………………………………………………….. NIM.20140400066

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