LEMBAR KUNJUNGAN (MONITORING) SISWA PSG TAHUN 2012

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No. Telpon DU/DI

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Nama-nama Siswa PSG

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Data Jurnal Siswa
No

Nama Siswa

Data Absensi Siswa

Sakit

Ijin

Ket

Alpha

2
3
4
Kendala-kendala yang Dihadapi Siswa
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Keluhan-keluhan DU/DI
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....................,....................2012
Pembimbing Eksternal

Pembimbing Internal

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Nama terang dan Stempel DU/DI

Nama terang