SURAT PERINTAH

NOMOR.................................................

Nama (yang memberi perintah) : ..................................................................................

Jabatan : ...................................................................................

MEMERINTAHKAN:

Kepada :
a. Nama : ..............................................................................................
b. Jabatan : ..............................................................................................

Untuk :
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Ditetapkan di : ...............................
Pada Tanggal : ………………………

Kepala Madrasah,

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NIP.