HIMPUNAN MAHASISWA JURUSAN KEPERAWATAN

FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN

UNIVERSITAS ISLAM NEGERI ALAUDDIN MAKASSAR
Jl. H. M Yasin Limpo No. 36 Samata Gowa,Kampus II Gedung FKIK (I) Lt.1 Telp.082154179941/085222577012

FORMULIR PENDAFTARAN ANGGOTA DIVISI KEPENGURUSAN

HIMPUNAN MAHASISWA JURUSAN (HMJ) KEPERAWATAN UIN ALAUDDIN

MAKASSAR 2018-2019

NAMA : Ayu satriana

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NIM : 70300117067

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TTL : Malaombo, 07 februari 1999

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SEMESTER/ANGKATAN : ...............1......................... / 2017

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ALAMAT LENGKAP : Asrama PIBA UINAM MAKASSAR

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MOTTO HIDUP : Orang tua

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NO. TELP/HP : 082292334115

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EMAIL/GMAIL : Ayusatriana070299@gmail.com

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NO. TELP/HP ORANG TUA/WALI : 085396694021

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 HIMPUNAN MAHASISWA JURUSAN KEPERAWATAN
FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN
UNIVERSITAS ISLAM NEGERI ALAUDDIN MAKASSAR
Jl. H. M Yasin Limpo No. 36 Samata Gowa,Kampus II Gedung FKIK (I) Lt.1 Telp.082154179941/085222577012

......................, ...... Januari 2018

Pendaftar,
FOTO
3 X 4 cm

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