LEMBAR BUKU INDUK ANAK DIDIK TK DHARMA WANITA DIKBUD 1 PANGKAJENE

2. Ibu kandung/wali : .....................................................................

a. N a m a : ......................................................................
b. Tempat dan tanggal lahir : .....................................................................
c. Agama : .....................................................................
d. Kewarganegaraan : .....................................................................
e. Pendidikan : .....................................................................
f. Pekerjaan : ......................................................................
g. Alamat : ......................................................................
h. Nomor telepon : ......................................................................

C. MUTASI
1. Diterima tanggal : ......................................................................
2. Ditempatkan dikelompok : ......................................................................
3. Berasal dari TK : ......................................................................
4. Meninggalkan TK karena : ......................................................................
Karena pindah/ melanjutkan *)
Ke..................................................................
D. JUMLAH KETIDAKHADIRAN

KELOMPOK KELOMPOK
KELOMPOK
SEMESTER I SEMESTER II SEMESTER I SEMESTER II

-Sakit ............... hari ...............hari ................hari ...............hari

-Izin ................hari ................hari ................hari ...............hari

-Tanpa ...............hari ................hari ................hari ...............hari

keterangan

E. KETERANGAN LAIN

1. Jarak tempat tinggalke Tk : ............................................................

2. pergi ke TK dengan : berkendaraan/berjalan kaki/antar jemput*)