KARTU KENDALI TEST KARTU KENDALI TEST

PPDB SMKN 1 PUNCAK CISARUA PPDB SMKN 1 PUNCAK CISARUA

TAHUN PELAJARAN 2021/2022 TAHUN PELAJARAN 2021/2022

NOMOR : ………………………………………………………. NOMOR : ……………………………………………………….

NAMA CALON SISWA : ………………………………………………………. NAMA CALON SISWA : ……………………………………………………….
NISN : ………………………………………………………. NISN : ……………………………………………………….
ASAL SEKOLAH : ………………………………………………………. ASAL SEKOLAH : ……………………………………………………….
ALAMAT RUMAH : ………………………………………………………. ALAMAT RUMAH : ……………………………………………………….

KEAHLIAN YANG DI PILIH KEAHLIAN YANG DI PILIH

1. TATA BOGA 3. OTKP 1. TATA BOGA 3. OTKP
2. PERHOTELAN 4. TKJ 2. PERHOTELAN 4. TKJ

1. A. TEST BUTA WARNA 1. A. TEST BUTA WARNA

B. KONDISI BACA B. KONDISI BACA

REKOMENDASI : REKOMENDASI :

2. TEST FISIK : 2. TEST FISIK :

A. TINDIK/TENDOK A. TINDIK/TENDOK
B. TATO B. TATO

REKOMENDASI : REKOMENDASI :

3. KELAINAN/PENYAKIT BAWAAN: 3. KELAINAN/PENYAKIT BAWAAN:

1 .................................................................................................................. 1 ..................................................................................................................
2 ....................................................................................................... 2 .......................................................................................................
3 ....................................................................................................... 3 .......................................................................................................

4. A. TINGGI BADAN : …………… CM 4. A. TINGGI BADAN : …………… CM

B. BERAT BADAN : …………… KG B. BERAT BADAN : …………… KG
C. TANDA-TANDA FISIK LAINNYA : C. TANDA-TANDA FISIK LAINNYA :

1 .................................................................................................................. 1 ..................................................................................................................
2 ....................................................................................................... 2 .......................................................................................................
3 ....................................................................................................... 3 .......................................................................................................

: KOORDINATOR : KOORDINATOR

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