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LAMPIRAN 1 :

FORM SURVEY/OBSERVASI LAPANGAN

Nama :………………………………………………………………….......
NIM :………………………………………………………………….......
Program studi :………………………………………………………………….......
Alamat : ………………………………………………………………….......
: RT....... RW ........
Desa/Kelurahan :………………………………………………………………...........
Kecamatan :………………………………………………………………….......
Kab./Kota : ………………………………………………………………….......
HASIL SURVEY/OBSERVASI LAPANGAN:

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PERMASALAHAN YANG DITEMUKAN:

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RENCANA PROGRAM YANG AKAN DILAKSANAKAN:

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Mengetahui: Semarang, ................................2020


KETUA RT/RW...... Kelurahan......... Mahasiswa

Tanda Tangan
Dan Cap Basah

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Menyetujui:
Dosen Pembimbing Lapangan

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