DPT PILKADES Gubuk Raden.xlsx

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No o NNo o KKKK NNIIKK NNaamma a TTeemmppaat t LLaahhiir r UUssiiaa

Alamat Alamat

Disab

Disabilitilitasas KetKeteraeranganngan*)*) Jalan/Dukuh

Jalan/Dukuh Rt Rt RwRw

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1 !!220011001100""002211##1100001 1 !!2200110011001100$$$$880000220 0 BBIILLIIN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$8 8 ""& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 2

2 !!220011001100""002211##1100001 1 !!2200110011##1100$$88220011$$8 8 SSAAIINNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&882 2 ""! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 "

" !!220011001100""11111122000022" " !!2200110011##1100$$$$&&00!!&&' ' SSUURRAATTMMIIN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$& "& "8 8 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 # ! 2

# ! 20011001100""11111122000022" " !!220011001111$$00''00000000001 1 MMUULLIIAADDI I SSAAPPUUTTRRA A GGUUBBUUK K RRAADDEEN N 11$$%%00''%%2200000 0 118 8 B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN 0N 0000 0 0000- - 00 !

! !!220011001100!!111111220000222 2 !!2200110011110000$$####0000001 1 NNUURRIINNI I GGUUBBUUK K RRAADDEEN N 1100%%00$$%%11&&''# !# !" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 '

' !!220011001100&&110011''000000& & !!2200110011001100$$88''0022##' ' PPAA((AAR R GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88' ' ""1 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 $ !

$ !2200110011112200&&11220000##1 1 !!220011001111221111''880000002 2 ))AARRDDO O CCIIPPTTO O ))IIYYOONNO O SSRRAAGGEEN N 1122%%1111%%11&&''8 8 ##& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN 0N 0000 0 0000- - 00 8 8 !!220011001111##112211110000''" " !!220011001111''1122$$220000001 1 SSAAIIMMAAN N GGUUBBUUK K RRAADDEEN N 11''%%1122%%11&&$$2 #2 #! ! S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 & & !!220011001111##112211110000''" " !!2200110011$$111122$$##0011110 0 AARRI I GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&$$# # ##" " S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 110 0 !!220011001111''00$$1122000011' ' !!2200110011!!##002200000000112 2 RRIINNI I AANNTTIIKKA A GGUUBBUUK K RRAADDEEN N 11##%%0022%%2200000 1 8 0 1 8 B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 111 1 !!2200110011220000##1122000000' ' !!2200110011##22002288''000000" " HHUURRIIAAH H GGUUBBUUK K RRAADDEEN N 0022%%0022%%11&&88' "' "2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 112 2 !!2200110011220000&&11""110011" " !!2200110011##1100$$88220011''' ' PPUUAASSA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&882 "2 "! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 11" " !!22001100112211111111110000##$ $ !!2200110011##1100$$$$""001111' ' SSAAKKDDIIAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$" #" ## # P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 11# # !!22001100112211111111110000##8 8 !!2200110011##1100$$''&&0000888 8 SSAAMMAAKKYYAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''& #& #8 8 P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 11! ! !!2200110011222200""11''0000008 8 !!220011001122""0011&&000000002 2 HHAASSAANNUUDDDDIIN N KKEEBBOON N AAYYU U 22""%%0011%%11&&&&0 20 28 8 B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 11' ' !!2200110011222200!!11""000000' ' !!2200110011001100$$88""00""11" " SSAALLIIKKIIN N PPEENNAARRUUKKAAN N LLAAUU* 0* 011%%00$$%%11&&88" "" "# # B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 11$ $ !!220011001122""00!!11220000001 1 !!220011001100!!00""$$000000001 1 MMIISSAANNA A GGUUBBUUK K RRAADDEEN N 00!!%%00""%%11&&$$0 #0 #8 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 118 8 !!220011001122""111111110000""& & !!2200110011001100$$''''0000##2 2 LLIIDDOOK K SSAARRI I GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''' ! 1 ' ! 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 11& & !!220011001122##111111110000""8 8 !!2200110011''!!11228888000000" " FFAATTRRIIAAH H GGUUBBUUK K RRAADDEEN N 22!!%%1122%%11&&888 28 2& & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 220 0 !!220011001122!!001111220000112 2 !!2200110011""11112288000011''" " MMAA))AARRDDI I GUGUBBUUK K RRAADDEEN N ""11%%1122%%11&&880 "0 "$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 221 1 !!220011001122!!001111220000112 2 !!2200110011!!''00&&88''0000001 1 MMUUSSTTIIRRAAH H GUGUBBUUK K RRAADDEEN N 11''%%00&&%%11&&88' "' "1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00

Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+

TAHUN 2018

: : A A A A : : N N : : O O K K : : K K A A A A : : : : 8 8 ( ( N N

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Alamat Alamat

Disab

Disabilitailitass KetKeteranerangan*gan*)) Jalan/Dukuh Jalan/Dukuh Rt Rt RwRw   !! "" ## $$ %% && '' ((   !! "" ## Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+ 222 2 !!220011001122!!00111122000011# # !!2200110011!!2200""88$$000000" " SSEERRIIAANNAAH H GUGUBBUUK K RRAADDEEN N 1122%%00""%%11&&88$ "$ "1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 22" " !!220011001122$$111111##000022' ' !!2200110011##1100$$&&110000''! ! SSAAIINNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&888 8 22& & B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 0000- - 00 22# # !!220011001100''00""0088''11&&& & !!2200110011001100$$''00000088# # RRIINNAASSIIH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''0 !0 !$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 0000" " 0000- - 00 22! ! !!220011001100''00""0088''11&&& & !!2200110011##1100$$$$0000##$$0 0 SSAAIIRRI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 0 ##$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 0000" " 0000- - 00 22' ' !!220011001100''00""0088''2222! ! !!2200110011001100$$''$$0022""# # MMAAHHYYUUN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 0000" " 0000- - 00 22$ $ !!220011001100''00""0088''2222! ! !!2200110011##1100$$''&&0011000 0 NNUURRMMAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''& #& #8 8 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 0000" " 0000- - 00 228 8 !!220011001100''00""0088''!!""8 8 !!2200110011##1100$$88!!0000""' ' RRAAMME E GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88! ! ""2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 0000" " 0000- - 00 22& & !!220011001100$$00""11110011$$$ $ !!2200110011!!##0088&&110000001 1 YYAATTNNI I GGUUBBUUK K RRAADDEEN N 11##%%0088%%11&&&&1 1 22' ' S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 0000" " 0000- - 00 ""0 0 0 0 !!2200110011##1100$$0088110000' ' NNUUR R ((EEMMBBAATTAAN N KKEEMMBBAAR R 0011%%00$$%%11&&''8 8 ##& & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ""1 1 0 0 !!2200110011001100$$88110011$$0 0 SSAAMMSSUUDDIIN N GUGUBBUUK K RRAADDEEN N 1100%%1111%%11&&880 0 ""$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ""2 2 0 0 !!2200110011##$$00118811!!00008 8 SSUUMMEENNAAH H PEPENNAARRUUKKAAN N LLAAUU* * 00$$%%0011%%11&&881 1 ""$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 """ " 0 0 !!220011001100$$001188##!!0000" " SSAARRIIMMAAHHAARRDDIIKKA A GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&88# # ""# # S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ""# # 0 0 !!2200110011##11001188$$!!0000& & SSIILLOOT T GGUUBBUUK K RRAADDEEN N 0011%%0011%%11&&88$ $ ""1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ""! ! 0 0 !!220011001100110011&&00!!00001 1 SSUURRIIA A GGUUBBUUK K RRAADDEEN N 0011%%0011%%11&&&&0 0 228 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ""' ' !!22001100110011002211110000002 2 !!2200110011""11112288##000088# # RRUUMMAASSA A GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&88# "# "" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ""$ $ !!2200110011001100""11110000##0 0 !!2200110011''##00##88""0000001 1 ((OOHHAARRIIYYAAH H GUGUBBUUK K RRAADDEEN N 22##%%00##%%11&&88" "" "! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ""8 8 !!2200110011001100""11110000##" " !!2200110011$$11112288110000110 0 SSUURRIIAAH H GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&881 "1 "' ' P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ""& & !!2200110011001100""11''0000002 2 !!2200110011$$11112288''0000""2 2 RRUUMMIISSAAH H GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&88' "' "1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ##0 0 !!2200110011002200##11##110000& & !!2200110011##!!1122&&##1100001 1 MMUUSSTTAA++IIYYAAH H GGUUBBUUK K RRAADDEEN N 00!!%%1122%%11&&&&# 2# 2" " S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ##1 1 !!22001100110022111111220000!!& & !!2200110011001100$$!!$$00''!!" " AAMMAA* * SSAAHHMMIIN N GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&$$! ! ##" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN 0N 0000 0 00000 0 00 ##2 2 !!220011001100""00""11110000##2 2 !!2200110011##''0088$$220000001 1 MMAARRIIAAH H GGUUBBUUK K RRAADDEEN N 00''%%0088%%11&&$$2 #2 #! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

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N

Alamat Alamat

Disab

Disabilitailitass KeteKeterangrangan*)an*) Jalan/Dukuh Jalan/Dukuh Rt Rt RwRw   !! "" ## $$ %% && '' ((   !! "" ## Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+

##" " !!220011001100""00""11110000##2 2 !!220011001100&&00$$$$$$0000001 1 AA. . UUDDIIN N GGUUBBUUK K RRAADDEEN N 00&&%%00$$%%11&&$$$ #$ #0 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ### # !!220011001100""11111122000022" " !!2200110011001100$$$$''00""11' ' SSAAMMIIUUN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$' #' #1 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ##! ! !!220011001100##002211""0000001 1 !!2200110011110000&&88!!0000002 2 ((UUNNAAIIDDI I GGUUBBUUK K RRAADDEEN N 1100%%0088%%11&&88! "! "2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ##' ' !!220011001100##002211""0000001 1 !!2200110011$$111122&&""0000!!$ $ MMAARRHHAAEENNI I GUGUBBUUK K RRAADDEEN N ""11%%1122%%11&&&&" 2" 2# # S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ##$ $ !!220011001100##111111""110000' ' !!22001100111111111188!!1100001 1 RRIIMMBBUUT T GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&88$ "$ "1 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ##8 8 !!220011001100##111111""110000' ' !!2200110011!!##00""88&&1100001 1 NNIICCA A ))AATTI I GUGUBBUUK K RRAADDEEN N 00$$%%0011%%11&&888 "8 "0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ##& & !!220011001100!!00""0088!!$$""$ $ !!2200110011001100$$''$$0011''& & EEKKA A MMUULLIIA A SSAAPPUUTTRRA A PPOOHHDDAANNA A 00##%%1100%%11&&888 8 22& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!0 0 !!220011001100!!00""0088!!$$""$ $ !!2200110011##221100&&""000000# # OOKKTTAARRIIAANNA A MMAAUULLIIDDA A GGEERRUUNNG G 1100%%0022%%11&&&&" 2 ! " 2 ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!1 1 !!220011001100!!00""0088''""&&' ' !!2200110011##1100$$$$$$1100##0 0 RRAASSIIH H GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&880 0 ""8 8 P P L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!2 2 !!220011001100!!00""0088''##''2 2 !!2200110011001100$$$$8800""### # SSAAHHRRIIM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$8 "8 "& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!" " !!220011001100!!00""0088''##''2 2 !!2200110011##1100$$8811000000! ! AASSIIAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&881 1 ""' ' S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!# # !!220011001100!!00""0088''&&00! ! !!2200110011""11112288##0011""' ' MMIISSAANNI I GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&88# "# "" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!! ! !!220011001100!!00""0088''&&$$1 1 !!2200110011##1100$$$$000000!!0 0 NNUURRIISSAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 #0 #$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!' ' !!220011001100!!00""0088''&&&&0 0 !!220011001100220011$$&&0000001 1 SSAAHHRRI I GGUUBBUUK K RRAADDEEN N 0022%%0011%%11&&$$& & ""& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!$ $ !!220011001100!!00""0088$$00000 0 !!2200110011##1100$$888800##22# # RRAAMMIINNAAH H PPEENNAARRUUKKAAN N LLAAUU* 0* 011%%00$$%%11&&888 2 & 8 2 & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!8 8 !!220011001100!!00""0088$$00##" " !!2200110011$$111122$$880011001 1 OOMMPPEEL L GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&$$8 "8 "& & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 !!& & !!220011001100!!00""0088$$00''2 2 !!2200110011001100$$88110022''2 2 MMUUSSTTAAMMAAN N GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&''& #& #& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''0 0 !!220011001100!!00""0088$$00''# # !!2200110011$$11112288&&0011008 8 KKAARRNNII))AATTI I GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&88& 2& 28 8 B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''1 1 !!220011001100!!00""0088$$11!!8 8 !!2200110011001100$$''$$000022! ! A A SSAAMMIIDDAAH H GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''2 2 !!220011001100!!00""0088$$11!!8 8 !!2200110011002200!!8822000000' ' SSAAIIRRAAH H GGUUBBUUK K RRAADDEEN N 2288%%00!!%%11&&882 "2 "' ' S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''" " !!220011001100!!00""0088$$1188! ! !!2200110011##1100$$&&00002222' ' SSIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&&&0 0 22$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

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Alamat Alamat

Disab

Disabilitailitass KetKeteranerangan*gan*)) Jalan/Dukuh Jalan/Dukuh Rt Rt RwRw   !! "" ## $$ %% && '' ((   !! "" ## Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+ ''# # !!220011001100!!00""0088$$2211" " !!2200110011!!1100''&&''1100001 1 SSUURRYYAANNI I GUGUBBUUK K RRAADDEEN N 1111%%00''%%11&&&&' 2 2 ' 2 2 B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''! ! !!220011001100!!00""0088$$22""! ! !!2200110011001100$$''$$0000$$" " A A LLIIDDOOK K GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''' ' !!220011001100!!00""0088$$22&&8 8 !!2200110011001100$$$$0000##""" " LLAANNCCAAR R GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 #0 #$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''$ $ !!220011001100!!00""0088$$22&&8 8 !!2200110011##1100$$$$''0022##" " SSAAMMIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$' #' #1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''8 8 !!220011001100!!00""0088$$22&&8 8 !!2200110011''""1111&&$$1100001 1 SSAARRAAKKIIYYAAH H GGUUBBUUK K RRAADDEEN N 22""%%1111%%11&&&&$ 2 0 $ 2 0 B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 ''& & !!220011001100!!00""0088$$##110 0 !!2200110011001100$$''!!00""221 1 SSAAHHAAR R GGUUBBUUK K RRAADDEEN N 1188%%1122%%11&&''8 #8 #& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$0 0 !!220011001100!!00""0088$$##&&8 8 !!2200110011##1100$$!!$$00##&&1 1 I I LLAASSEEM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&!!$ '$ '0 0 P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$1 1 !!220011001100!!00""0088$$##&&8 8 !!2200110011##1100$$&&##00""##1 1 SSOOLLEEHHA A PPEENNAARRUUKKAAN N LLAAUU* 1* 122%%1100%%11&&&&! 2! 22 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$2 2 !!220011001100!!00""0088$$!!""2 2 !!2200110011001100$$''$$0000$$8 8 AAMMAA* * TTAAHHRRIIM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ $ !!0 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$" " !!220011001100!!00""0088$$!!""& & !!2200110011##1100$$$$000000$$' ' RRUUMMAASSIIH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 #0 #$ $ P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$# # !!220011001100!!00""0088$$!!88' ' !!2200110011001100$$&&!!00##111 1 SSUU++UUD D GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&&&" " 22! ! S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$! ! !!220011001100!!00""0088$$!!&&2 2 !!2200110011##1100$$882200$$##1 1 SSAARRIIMMA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&882 "2 "! ! P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$' ' !!220011001100!!00""0088$$!!&&# # !!2200110011##1100$$''!!0011''& & I I MMAAIIDDOOK K GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''! !! !2 2 P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$$ $ !!220011001100!!00""0088$$!!&&# # !!2200110011##1100$$&&""0000''0 0 MMUUHHIIMMAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&&&" 2" 2# # S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$8 8 !!220011001100!!00""0088$$!!&&8 8 !!2200110011001100$$&&1100""$$2 2 PPAA((RRI I GGUUBBUUK K RRAADDEEN N 1122%%00!!%%11&&88& & 22& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 $$& & !!220011001100!!00""0088$$!!&&8 8 !!2200110011##1100$$88$$0000!!& & MMUUSSLLIIMMAAH H GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88$ "$ "0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 880 0 !!220011001100!!00""0088$$!!&&8 8 !!2200110011001100$$000000""!!' ' SSAAHHRRI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%2200000 0 11$ $ B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 881 1 !!220011001100!!00""0088$$''00# # !!2200110011001100$$000000""!!! ! ))AA))AAN N FFEEBBRRIIAAN N GGUUBBUUK K RRAADDEEN N 1122%%0022%%2200001 1 11$ $ B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN 0N 0000 0 00000 0 00 882 2 !!220011001100!!00""0088$$''22$ $ !!2200110011001100$$$$$$00!!$$2 2 SSAAEEFFUUL L BBAAHHRRI I GGUUBBUUK K RRAADDEEN N 0022%%1100%%11&&$$1 # ' 1 # ' S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 88" " !!220011001100!!00""0088$$''22$ $ !!2200110011##1100$$880000!!''! ! HHAARRIIAATTUUN N GOGONNDDAA))AARRI I NNAARRMMA A 00&&%%0011%%11&&881 " $ 1 " $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 88# # !!220011001100!!00""0088$$''""1 1 !!2200110011001100$$''##0000008 8 BBEERRSSIINNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''# !# !" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

(5)

N

Alamat Alamat

Disab

Disabilitailitass KeteKeterangrangan*)an*) Jalan/Dukuh Jalan/Dukuh Rt Rt RwRw   !! "" ## $$ %% && '' ((   !! "" ## Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+ 88! ! !!220011001100!!00""0088$$''""1 1 !!2200110011##1100$$''$$00$$!!0 0 MMAARRIILLAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 88' ' !!220011001100!!00""008888$$''8 8 !!22001100110011001188000000008 8 NNAASSRRUUDDIIN N GUGUBBUUK K RRAADDEEN N 0011%%0011%%11&&880 "0 "8 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 88$ $ !!220011001100!!00##1111000000$ $ !!2200110011""001122$$''000000$ $ MMUUNNAASSIIP P GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&''& #& #& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 888 8 !!220011001100!!00''11""000000$ $ !!2200110011001100$$''&&00##118 8 SSUUHHAAIILLI I PPEENNAARRUUKKAAN N LLAAUUK 0K 011%%00$$%%11&&''& #& #8 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 88& & !!220011001100!!00''11""000000$ $ !!2200110011##1100$$$$$$00&&""! ! MMAASSNNI I GUGUBBUUK K RRAADDEEN N 0011%%0022%%11&&$$2 2 ##' ' S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&0 0 !!220011001100!!00''11""000000$ $ !!2200110011!!881122&&880000001 1 IISSNNAA))AATTI I GUGUBBUUK K RRAADDEEN N 1188%%1122%%11&&&&8 18 1& & B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&1 1 !!220011001100!!00''11$$000000" " !!2200110011001100$$$$$$00""!!" " SSAAHHNNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$$ $ ##0 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&2 2 !!220011001100!!11111122000022& & !!2200110011''$$00$$&&!!0000002 2 SSUUHHAARRTTI I GUGUBBUUK K RRAADDEEN N 22$$%%00$$%%11&&&&! 2! 22 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&" " !!220011001100!!111111##0000111 1 !!2200110011##1100$$$$$$00''88# # ((AANNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$$ #$ #0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&# # !!220011001100''00""0088##""11" " !!2200110011##1100$$&&220000881 1 RRIIAASSIIH H GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&88! "! "" " S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&! ! !!220011001100''00""0088!!$$$$# # !!2200110011001100$$!!880000##2 2 AAMMAA* * NNUURRSSIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&!!8 8 !!& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&' ' !!220011001100''00""0088!!$$$$# # !!2200110011##1100$$''2200""11# # IINNAA* * SSIIAAMMA A GUGUBBUUG G RRAADDEEN N 0011%%00$$%%11&&''2 ! ! 2 ! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&$ $ !!220011001100''00""0088!!$$$$$ $ !!2200110011001100$$''!!0022##! ! MMIISSAANNA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''! !! !2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&8 8 !!220011001100''00""0088!!$$$$$ $ !!2200110011##1100$$''''000011& & RRUUMMIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''' !' !1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 &&& & !!220011001100''00""0088!!8888" " !!2200110011##!!00$$&&""000000' ' NNUURR((AANNAAH H PEPENNAARRUUKKAAN N DDAAYYA A 00!!%%00$$%%11&&&&" 2 # " 2 # S S P P DUDUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11000 0 !!220011001100''00""0088!!&&00$ $ !!220011001100$$!!''0000!!2 2 A A RRAAMMIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&!!' '' '1 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11001 1 !!220011001100''00""0088!!&&00$ $ !!2200110011##1100$$''$$00''''" " I I KKIINNUUN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11002 2 !!220011001100''00""0088!!&&220 0 !!2200110011001100$$$$0000!!002 2 KKAARRDDI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 #0 #$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1100" " !!220011001100''00""0088!!&&220 0 !!2200110011##1100$$$$2200''''& & I I CCAAMMIIK K GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$2 #2 #! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1100# # !!220011001100''00""0088!!&&228 8 !!220011001100##00$$''000000001 1 ((AANNIIAAH H GGUUBBUUK K RRAADDEEN N 00##%%00$$%%11&&''0 !0 !$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1100! ! !!220011001100''00""0088!!&&""0 0 !!2200110011111100##$$&&000000" " YYUUDDIIN N GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&$$1 #1 #' ' S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

(6)

N

Alamat Alamat

Disab

Disabilitailitass KetKeteranerangan*)gan*) Jalan/Dukuh Jalan/Dukuh Rt Rt RwRw   !! "" ## $$ %% && '' ((   !! "" ## Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+

1100' ' !!220011001100''00""0088!!&&""# # !!2200110011##880022$$''0000001 1 I I NNUURRIINNAAH H BBOONNGGOOR R 0088%%0022%%11&&$$' ' ##2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1100$ $ !!220011001100''00""0088!!&&##0 0 !!2200110011##1100$$!!!!0011!!$ $ MMEERRSSAANNI I GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&!!! '! '2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11008 8 !!220011001100''00""0088''00""8 8 !!2200110011001100$$$$""0000!!0 0 AAMMAA* * NNAA))IISSAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$" " ##! ! S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN 0N 0000 0 00000 0 00 1100& & !!220011001100''00""0088''00##2 2 !!2200110011001100$$88!!00""112 2 MMUUHHYYAAR R GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88! "! "2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11110 0 !!220011001100''00""0088''00!!2 2 !!2200110011001100$$$$&&0022!!2 2 AAMMAA* * MMUUSSLLIIM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$& " 8 & " 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11111 1 !!220011001100''00""0088''00!!2 2 !!2200110011##1100$$88880022&&8 8 HHAAEERRIIAAH H PPEENNAARRUUKKAAN N LLAAUU* 0* 011%%00$$%%11&&888 2 & 8 2 & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11112 2 !!220011001100''00""0088''00''0 0 !!2200110011001100$$$$22001122! ! AAMMSSIIOOK K GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$2 #2 #! ! S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1111" " !!220011001100''00""0088''00''0 0 !!2200110011##1100$$$$!!0011000 0 OOMMPPEEL L GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$! #! #2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1111# # !!220011001100''00""0088''00''0 0 !!2200110011112200$$&&$$1100002 2 SSUUPPRRIIAADDI I GUGUBBUUK K RRAADDEEN N 1122%%00$$%%11&&&&$ 2$ 20 0 B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1111! ! !!220011001100''00""0088''00''! ! !!2200110011''111100$$$$0000001 1 IINNAA* * SSAARRIIMMAAN N GGUUBBUUK K RRAADDEEN N 1111%%1100%%11&&$$$ $ ##1 1 P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1111' ' !!220011001100''00""0088''00$$# # !!2200110011001100$$$$##0011$$& & AAMMAA* * YYAATTNNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&##! ! $$2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1111$ $ !!220011001100''00""0088''00$$# # !!2200110011##1100$$$$!!0000!!& & SSIINNAAH H PPEENNAARRUUKKAAN N DDAAYYA 0 1A 0 1%%00$$%%11&&$$! #! #2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11118 8 !!220011001100''00""0088''00$$# # !!2200110011##1100$$88880000!!2 2 YYAATTMMI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&888 28 2& & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1111& & !!220011001100''00""0088''00$$' ' !!2200110011##1100$$!!''0022111 1 RRAAIISSAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&!!8 !8 !& & P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11220 0 !!220011001100''00""0088''00$$' ' !!2200110011##1100$$88!!00##228 8 FFAAII,,AAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88! "! "2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11221 1 !!220011001100''00""0088''00880 0 !!2200110011001100$$''!!0022!!$ $ A A IIMMAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''! !! !2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11222 2 !!220011001100''00""0088''11!!$ $ !!2200110011001100$$$$2200$$##' ' NNUURRSSIIMMAAH H GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$2 #2 #! ! S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1122" " !!220011001100''00""0088''11!!$ $ !!2200110011##1100$$$$!!0000$$! ! NNUURRIIMMAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$! #! #2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1122# # !!220011001100''00""0088''11''0 0 !!2200110011001100$$88220011""& & PPAA((AARRUUDDDDIIN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88' " 1 ' " 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1122! ! !!220011001100''00""0088''11''# # !!2200110011##1100$$$$!!0000''& & AASSIIAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$! #! #2 2 P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1122' ' !!220011001100''00""0088''11''# # !!2200110011##1100$$88!!00##""2 2 MMAARRIINNA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88! "! "2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

(7)

N

Alamat Alamat

Disab

1122$ $ !!220011001100''00""0088''11''8 8 !!2200110011##1100$$''2200""!!0 0 LLAASSIIH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''2 !2 !! ! P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11228 8 !!220011001100''00""0088''11$$' ' !!2200110011001100$$$$0000##88! ! MMAAHHSSUUN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 #0 #$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1122& & !!220011001100''00""0088''11$$' ' !!2200110011##1100$$$$11002222' ' NNUURRIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$1 #1 #' ' S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""0 0 !!220011001100''00""0088''11$$' ' !!2200110011001100$$88&&00!!''& & RRIIPPAA++I I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&&&1 21 2' ' S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""1 1 !!220011001100''00""0088''11$$8 8 !!2200110011##1100$$$$&&00##000 0 SSAAHHNNI I LLEENNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$& " 8 & " 8 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""2 2 !!220011001100''00""0088''1188$ $ !!2200110011001100$$''$$0022##" " A A SSIITTAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""" " !!220011001100''00""0088''22110 0 !!2200110011##1100$$''##0022000 0 SSAAPPIIRRAAH H BBAAKKOON N DDAASSAAN N 0011%%00$$%%11&&''# !# !" " S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""# # !!220011001100''00""0088''2211' ' !!2200110011##1100$$$$110011""& & SSIIMMA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''0 0 !!$ $ P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""! ! !!220011001100''00""0088''22&&0 0 !!2200110011##1100$$$$0000##88' ' MMAASSIITTAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 #0 #$ $ P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""' ' !!220011001100''00""0088''""""" " !!2200110011##1100$$$$!!00''22! ! SSAAPPIIRRAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$$ #$ #0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""$ $ !!220011001100''00""0088''""""" " !!2200110011001100$$$$&&0022##' ' KKAASSIIRRIIN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$& "& "8 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""8 8 !!220011001100''00""0088''""""" " !!2200110011##1100$$&&8800""##' ' EEKKA A OOKKTTAAVVIIAANNI I GGUUBBUUK K RRAADDEEN N 11""%%1122%%11&&&&' ' 221 1 B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11""& & !!220011001100''00""0088''""!!! ! !!2200110011001100$$''220011''' ' SSAAKKRRAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''2 !2 !! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11##0 0 !!220011001100''00""0088''##008 8 !!2200110011001100$$880000!!000 0 ((AAMMIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&880 "0 "$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11##1 1 !!220011001100''00""0088''##11' ' !!2200110011001100$$''!!0022$$& & AAMMAA* * RRIIAATTA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''! ! !!2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11##2 2 !!220011001100''00""0088''##11' ' !!2200110011##1100$$''$$0000##1 1 ((AAMMIIDDAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11##" " !!220011001100''00""0088''##11& & !!2200110011##1100$$!!880011$$0 0 IINNAA* * MMEERRTTA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&!!8 8 !!& & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11### # !!220011001100''00""0088''##222 2 !!2200110011!!&&0088$$000000002 2 SSAAKKMMAAH H GGUUBBUUK K RRAADDEEN N 11&&%%0088%%11&&$$0 #0 #$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11##! ! !!220011001100''00""0088''##""1 1 !!2200110011001100$$''!!0022$$2 2 AA. . MMIINNGGGGU U GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''! !! !2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11##' ' !!220011001100''00""0088''##""1 1 !!2200110011##1100$$''''0011$$2 2 MMAARRSSI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''' !' !1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11##$ $ !!220011001100''00""0088''##""1 1 !!2200110011001100$$88##00""11" " ((UUMMAAIIN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88# "# "" " B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

(8)

N

Alamat Alamat

Disab

11##8 8 !!220011001100''00""0088''##""1 1 !!2200110011!!8800!!&&$$0000002 2 LLIILLI I SSUURRYYAANNI I PPEEKKEENNDDEENNGGAAN N 1188%%00!!%%11&&&&$ 2$ 21 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11##& & !!220011001100''00""0088''##!!8 8 !!2200110011##1100$$88!!0000""! ! AAMMAA* * SSIINNAAH H GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&##$ $ $$1 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!0 0 !!220011001100''00""0088''##!!8 8 !!2200110011##1100$$$$000000""$ $ IINNAA* * MMEELLUUK K GUGUBBUUK K RRAADDEEN N 00$$%%0011%%11&&''0 0 !!8 8 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!1 1 !!220011001100''00""0088''##''! ! !!2200110011##1100$$$$0000''220 0 SSAARRIIA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 #0 #$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!2 2 !!220011001100''00""0088''##''! ! !!2200110011001100$$&&000000""0 0 SSUULLIIA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&&&0 20 2$ $ B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!" " !!220011001100''00""0088''##''! ! !!2200110011##1100$$00000000!!8 8 AAPPRRIIAANNTTI I GUGUBBUUK K RRAADDEEN N 0011%%00$$%%2200000 10 1$ $ B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!# # !!220011001100''00""0088''##$$8 8 !!2200110011001100$$$$""00""""8 8 AA. . SSIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$" #" ## # S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!! ! !!220011001100''00""0088''##$$8 8 !!2200110011##1100$$$$""0022112 2 SSAAIINNUUN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$" #" ## # S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!' ' !!220011001100''00""0088''##881 1 !!2200110011001100$$$$220011222 2 AAMMAAT T GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$2 2 ##! ! S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!$ $ !!220011001100''00""0088''##88! ! !!2200110011001100$$$$##002200" " SSAAHHNNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$# ## #" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!8 8 !!220011001100''00""0088''##88! ! !!2200110011##1100$$$$$$008822& & PPIISSAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$$ #$ #0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11!!& & !!220011001100''00""0088''##88! ! !!2200110011111100##&&$$000000" " MMUUHH. . HHAAMMDDI I GGUUBBUUK K RRAADDEEN N 1111%%00##%%11&&&&$ $ 221 1 B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''0 0 !!220011001100''00""0088''##88& & !!2200110011!!##00&&88000000001 1 MMAAHHRRI I PPEENNAARRUUKKAAN N DDAAYYA 1 #A 1 #%%00&&%%11&&880 "0 "$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''1 1 !!220011001100''00""0088''!!000 0 !!2200110011##1100$$''$$00$$22! ! MMUULLUUT T GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''2 2 !!220011001100''00""0088''!!000 0 !!2200110011##2200""&&&&0000002 2 KKAARRNNII))AATTI I GGUUBBUUK K RRAADDEEN N 0022%%00""%%11&&&&& 1& 1& & B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''" " !!220011001100''00""0088''!!$$" " !!2200110011001100$$$$110011''2 2 A A BBAANNGGGGO O GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$1 #1 #' ' S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''# # !!220011001100''00""0088''!!$$" " !!2200110011001100$$88!!00""00# # SSUULLAAEEMMAAN N KKEEBBOON N AAYYU U ""00%%00''%%11&&88& 2& 28 8 B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''! ! !!220011001100''00""0088''''''' ' !!2200110011001100$$$$$$00##110 0 SSUURRAAMMA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$$ #$ #0 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''' ' !!220011001100''00""0088''''''' ' !!2200110011##1100$$$$&&00!!22# # KKAALLSSUUM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$& "& "8 8 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''$ $ !!220011001100''112200&&0000112 2 !!22001100111100001188110000002 2 MMAAHHYYUUN N GGUUBBUUK K RRAADDEEN N 1100%%0011%%11&&881 "1 "$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11''8 8 !!220011001100''112200&&0000112 2 !!2200110011##8800&&88!!000000! ! NNUURR++AAIINNI I GGUUBBUUK K RRAADDEEN N 0088%%00&&%%11&&88! "! "2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

(9)

N

Alamat Alamat

Disab

11''& & !!220011001100''112211""1100001 1 !!2200110011001100$$88!!00##000 0 DDUURRAAHHIIM M GGUUBBUUK K RRAADDEEN N 11##%%00''%%11&&88$ "$ "1 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$0 0 !!220011001100$$00""1111001111" " !!2200110011!!8800''88880000001 1 YYUULLIIAANNA A RRIISSKKIIAAH H BBOONNDDOO))OOSSO O 11''%%00''%%11&&888 8 ""0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$1 1 !!220011001100$$00!!11220000002 2 !!220011001100!!008888880000002 2 MMUUNNIIR R GGUUBBUUK K RRAADDEEN N 00!!%%0088%%11&&888 28 2& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$2 2 !!2200110011008800""1111000022! ! !!2200110011""111122$$&&0000$$! ! MMAAYYAADDI I GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&&&0 20 28 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$" " !!2200110011008800""11220000221 1 !!2200110011##1100$$$$$$0022##' ' ((AASSIIMMAAH H GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&''& #& #& & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$# # !!220011001100&&00''11110000001 1 !!220011001100&&1100$$""0000002 2 SSAAIINNAAH H GGUUBBUUK K RRAADDEEN N 00&&%%1100%%11&&''! !! !2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$! ! !!220011001100&&00''11110000001 1 !!2200110011!!881111&&&&1100001 1 NNUURRUUL L AAIINNI I GGUUBBUUK K RRAADDEEN N 1188%%1111%%11&&&&& & 118 8 B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$' ' !!22001100111100002211''000011' ' !!2200110011##1100$$$$''002200! ! FFAATTIIMMAAH H GGUUBBUUK K RRAADDEEN N 1100%%00$$%%11&&888 28 2& & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$$ $ !!2200110011110000""1111000011" " !!2200110011##1100$$88!!0000''& & SSAAKKNNAAH H PPEENNAARRUUKKAAN N LLAAUU* 0* 011%%00$$%%11&&88! "! "2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11$$8 8 !!2200110011110000&&11##0000220 0 !!2200110011##1100$$''11001111' ' HH((. . SSIITTI I HHAAEERRIIAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''1 1 !!' ' S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN 0N 0000 0 00000 0 00 11$$& & !!22001100111100110011''000000& & !!2200110011##1100$$&&$$0000""$ $ BB* * MMUUSSTTIIAANNI I EENNDDOOK K 22!!%%00$$%%11&&&&! ! 222 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11880 0 !!2200110011111100$$11''000000" " !!2200110011$$111122$$##0000''0 0 KKAASSIIMMAAH H GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&$$# ## #" " S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11881 1 !!22001100111122002211!!0000''! ! !!2200110011##1100$$$$""0022""! ! SSAAIINNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ $ !!0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11882 2 !!2200110011112200&&11220000##1 1 !!2200110011##1100$$$$''00""&&& & SSAAEENNDDUUN N GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$' #' #2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1188" " !!220011001111""00##1111000000# # !!2200110011##1100$$882200$$00$ $ MMAAHHNNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&882 "2 "! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1188# # !!220011001111""00##11110000112 2 !!2200110011!!!!00""$$$$0000001 1 PPUUAASSA A GGUUBBUUK K RRAADDEEN N 0011%%0011%%11&&$$$ #$ #1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1188! ! !!220011001111""00##11""000000! ! !!2200110011001100$$$$""00""""2 2 BBOOHHAARRI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$" #" ## # S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1188' ' !!220011001111""00##11""000000! ! !!2200110011##1100$$$$##110000& & SSIILLAAH H PPEENNAARRUUKKAAN N LLAAUU* * 00$$%%0011%%11&&$$# ## ## # S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1188$ $ !!220011001111""00##1188##00001 1 !!2200110011##$$0011$$$$##00002 2 NNUURRIINNAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&##$ $$ $0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11888 8 !!220011001111""00##1188##00001 1 !!2200110011001100$$!!!!##0000# # AAMMAA* * RRIINNAAYYUUN N GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&!!! ! ''2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 1188& & !!220011001111""00##1188##00001 1 !!2200110011""111122!!$$##00002 2 AAMMAA* * MMAAIINNAAH H GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&!!$ ' 0 $ ' 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

(10)

N

Alamat Alamat

Disab

Disabilitailitass KetKeteraeranganngan*)*) Jalan/Dukuh Jalan/Dukuh Rt Rt RwRw   !! "" ## $$ %% && '' ((   !! "" ## Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+

11&&0 0 !!220011001111""00##1188##00001 1 !!2200110011##1100$$''00##0000& & IINNAA* * SSRRIIM M GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''0 ! $ 0 ! $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&1 1 !!220011001111""00##1188##00001 1 !!2200110011001100$$''22##00002 2 SSAAYYUUKKI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''2 !2 !! ! P P L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&2 2 !!220011001111""00##1188##00001 1 !!2200110011##1100$$''''##0000" " SSAAYYUUDDI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''' !' !1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&" " !!220011001111""00##1188##00001 1 !!2200110011##1100$$''$$##0000' ' I I SSAARRIINNAAH H GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&# # !!220011001111""00##1188##00001 1 !!2200110011##1100$$$$2200''##1 1 ((UUMMAAK K GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&! ! !!220011001111""00##1188##00001 1 !!2200110011##1100$$''$$##0000! ! I I KKAALLAAM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&' ' !!220011001111""00##1188##00001 1 !!2200110011##1100$$''$$##0000$ $ MMAASSIIH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''$ !$ !0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&$ $ !!220011001111""00##1188##00001 1 !!2200110011""111122''&&##00002 2 BBAAGGOOR R GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&''& #& #8 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&8 8 !!220011001111""00##1188##00001 1 !!2200110011001100$$''&&##0000" " SSAAIIDDAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&''& #& #8 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 11&&& & !!220011001111""00##1188##00001 1 !!2200110011$$111122''&&##0000' ' SSAARRI I GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&''& & ##8 8 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22000 0 !!220011001111""00##1188##00001 1 !!220011001111!!1122$$00##00001 1 AASSIIH H GGUUBBUUK K RRAADDEEN N 11!!%%1122%%11&&$$0 0 ##$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22001 1 !!220011001111""00##1188##00001 1 !!2200110011##''0022$$""##00001 1 ((UUMMAAK K GGUUBBUUK K RRAADDEEN N 00''%%0022%%11&&$$" #" #! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22002 2 !!220011001111""00##1188##00001 1 !!220011001111$$0011$$####00001 1 NNUURRSSAALLIIM M GGUUBBUUK K RRAADDEEN N 11$$%%0011%%11&&$$# ## ## # S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2200" " !!220011001111""00##1188##00001 1 !!2200110011001100$$$$!!##0000' ' NNUURRPPAA++AAT T GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$! #! #2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2200# # !!220011001111""00##1188##00001 1 !!2200110011""111122$$$$##00002 2 RRAAMMIINNAAH H GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&$$$ #$ #0 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2200! ! !!220011001111""00##1188##00001 1 !!2200110011##1100$$$$88##00110 0 SSAARRIIA A GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$8 "8 "& & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2200' ' !!220011001111""00##1188##00001 1 !!220011001100&&11008800##00002 2 RRUUSSDDAAN N GGUUBBUUK K RRAADDEEN N 00&&%%1100%%11&&880 "0 "$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2200$ $ !!220011001111""00##1188##00001 1 !!2200110011##$$00118800##0000" " TTIIRRAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&880 "0 "$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22008 8 !!220011001111""00##1188##00001 1 !!2200110011222200888800##00001 1 HHAAMMDDI I GGUUBBUUK K RRAADDEEN N 2222%%0088%%11&&880 "0 "$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2200& & !!220011001111""00##1188##00001 1 !!2200110011##1100118800##00001 1 SSEERRI I GGUUBBUUK K RRAADDEEN N 0011%%0011%%11&&880 0 ""8 8 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22110 0 !!220011001111""00##1188##00001 1 !!2200110011""11112288####00002 2 MMUUSSTTAAMMIIN N GUGUBBUUK K RRAADDEEN N ""11%%1122%%11&&88# "# "" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

(11)

N

Alamat Alamat

Disab

Disabilitailitass KetKeteranerangan*gan*)) Jalan/Dukuh Jalan/Dukuh Rt Rt RwRw   !! "" ## $$ %% && '' ((   !! "" ## Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+ 22111 1 !!220011001111""00##1188##00001 1 !!2200110011001100$$88!!##00008 8 MMUUSSLLIIM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88! "! "2 2 B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22112 2 !!220011001111""00##1188##00001 1 !!220011001100$$001188!!##00001 1 CCAANNI I GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&88! ! """ " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2211" " !!220011001111""00##1188##00001 1 !!2200110011001100$$888800##112 2 GGIILLAANNG G RRUUSSDDI I GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&888 " 0 8 " 0 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2211# # !!220011001111""00##1188##00001 1 !!2200110011001100$$88&&##0000$ $ YYUUDDI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88& & 228 8 B B L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2211! ! !!220011001111""00##1188##00001 1 !!2200110011##$$0011&&00##0000" " SSIITTI I MMUULLIIAANNA A TTEELLAAGGA A ))AARRU U ""11%%1122%%11&&&&0 2 $ 0 2 $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2211' ' !!220011001111""00##1188##00001 1 !!220011001100$$0011&&11##00001 1 NNUURRSSAALLIIM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&&&0 20 2$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2211$ $ !!220011001111""00##1188##00001 1 !!2200110011##$$0011&&""##0000# # SSAAHHNNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&&&" 2" 2# # B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22118 8 !!220011001111""00##1188##00001 1 !!2200110011##!!00''&&''##00001 1 DDAALLIISSAAH H GGUUBBUUK K RRAADDEEN N 00!!%%00''%%11&&&&' 2' 22 2 B B P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2211& & !!220011001111""00881122000022! ! !!2200110011""11112288""0011""' ' RRAAHHMMAAN N GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&88! "! "2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22220 0 !!220011001111''00''11""000000# # !!2200110011##""00888822000000" " SSAAHHNNI I AAYYUUNNI I GGUUBBUUK K RRAADDEEN N 00""%%0088%%11&&882 2 ""! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22221 1 !!220011001111''112211""110000' ' !!2200110011118800!!88""0000001 1 SSUUHHAAEELLI I GGUUBBUUK K RRAADDEEN N 1188%%00!!%%11&&88" "" "! ! S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22222 2 !!220011001111$$00111122000000# # !!22001100110011112288!!0000002 2 NNAASSIIP P GGUUBBUUK K RRAADDEEN N 0011%%1122%%11&&88! "! "2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2222" " !!220011001111$$111111""1100110 0 !!220011001100110022$$&&1100001 1 MMAAHHDDI I GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&$$# ## ## # S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2222# # !!220011001111$$111111""1100110 0 !!2200110011##1100$$$$&&110000$ $ I I RRAAMMIINNAAH H GUGUBBUUK K RRAADDEEN N 00$$%%0011%%11&&$$& " & & " & S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2222! ! !!2200110011118800$$11''000011! ! !!220011001111''11118888000000" " NNUURRSSIINNI I GGUUBBUUK K RRAADDEEN N 11''%%1111%%11&&888 28 2& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2222' ' !!2200110011118800&&1122000000$ $ !!220011001100''00&&$$22000000" " NNUURRIILLAAH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&&&0 20 2$ $ P P P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 2222$ $ !!220011001111&&00##1111000022& & !!2200110011##1100$$$$000000!!2 2 I I SSEERRIIM M GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&$$0 #0 #$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22228 8 !!220011001111&&00''11!!000000' ' !!22001111""##2200!!&&22000000! ! DD))I I NNUURRUUL L HHAANNDDAAYYAANNI I DDOOMMPPU U 0022%%00!!%%11&&&&2 2 22' ' S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN 0N 0000 0 00000 0 00 2222& & !!2200110011220000&&11""1100111 1 !!2200110011""111122''88110000" " SSAAMMI I GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&''$ $ !!1 1 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""0 0 !!2200110011220000&&11""1100111 1 !!2200110011''""0011&&##1100001 1 SSUUMMAARRNNI I GUGUBBUUK K RRAADDEEN N 00$$%%0011%%11&&&&" 2" 2! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""1 1 !!2200110011221100##11##000000" " !!2200110011002200''88##0000002 2 NNUURRAASSIIH H GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&88! "! "" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00

(12)

N

Alamat Alamat

Disab

Disabilitailitass KetKeteranerangan*gan*)) Jalan/Dukuh Jalan/Dukuh Rt Rt RwRw   !! "" ## $$ %% && '' ((   !! "" ## Tanggal Tanggal Lahir Lahir tatus tatus +erkawinan +erkawinan ,//+ ,//+ Jenis Jenis Kelamin Kelamin L/+ L/+

22""2 2 !!2200110011221100&&11""1100002 2 !!2200110011##1100$$8888110000& & RRAAKKMMAAH H GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&88' "' "2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""" " !!2200110011222200""11''0000008 8 !!22001100$$!!22112288&&000000" " SSUUKKIILLA A LLAABBUUAAN N PPOOH H 0011%%0022%%11&&&&! ! 22" " S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""# # !!2200110011222200!!11""0000008 8 !!2200110011$$111122&&000000&&& & MMAAHHYYU U GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&&&# 2# 2# # S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""! ! !!220011001122""00!!11220000002 2 !!2200110011!!&&00''&&110000002 2 SSUUPPAARRNNI I GUGUBBUUK K RRAADDEEN N 1122%%00!!%%11&&&&1 21 2$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""' ' !!220011001122""00!!1122000000# # !!2200110011""111122$$!!002222$ $ SSAAMMI I GGUUBBUUK K RRAADDEEN N ""11%%1122%%11&&$$! ! ##2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""$ $ !!220011001122""00!!1122000000# # !!2200110011''110022$$$$0000002 2 SSEERRIIM M GGUUBBUUK K RRAADDEEN N 2211%%0022%%11&&$$$ #$ #1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""8 8 !!220011001122""00!!1122000000# # !!220011001100$$112288!!1100001 1 TTAAHHRRIIM M GGUUBBUUK K RRAADDEEN N 00$$%%1122%%11&&88! "! "2 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22""& & !!220011001122""00!!11''0000221 1 !!2200110011001100$$88880000##& & MMAAHHLLI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&888 28 2& & S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22##0 0 !!220011001122""00&&1122000022! ! !!2200110011001100$$$$##00""00& & AAMMAA* * SSEENNAAH H GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&!!2 2 ''' ' S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22#1 #1 !2!2010101012"2"11111$1$00000$ !0$ !202010101#1#1010$&$&000!0!&0 &0 ETETI I SRSRI I SUSUSISILLO O DEDE)I )I PEPENANARURUKAKAN N DADAYYA A 001%1%001%1%1&1&&0 &0 28 28 S S P P DUDUSUSUN N GGUBUBUK UK RARADEDEN 00N 000 0 0000 00 00 22##2 2 !!220011001122##002211!!000022# # !!2200110011##1100$$88!!00##112 2 RRIIAASSIIH H GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88! "! "2 2 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22##" " !!220011001122##00!!11110000!!$ $ !!2200110011001100$$88$$0011''' ' SSAARRIIMMAAN N PPEENNAARRUUKKAAN N DDAAYYA 0 1A 0 1%%00$$%%11&&88$ "$ "0 0 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22### # !!220011001122##00!!11110000&&" " !!2200110011001100$$88##00##001 1 RRAASSIINNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88# "# "" " S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22##! ! !!220011001122##00!!11110000&&" " !!2200110011##1100$$88''00##22" " SSUUHHEERRNNI I GUGUBBUUK K RRAADDEEN N 0011%%00$$%%11&&88' "' "1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22##' ' !!220011001122!!00111122000011# # !!22001100111111111188!!000000" " HHEERRMMAAN N GUGUBBUUK K RRAADDEEN N 1111%%1111%%11&&88! " 2 ! " 2 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22##$ $ !!220011001122''00&&11$$0000002 2 !!2200110011##&&00""&&##000000" " MMEERRIIAANNDDAANNI I GGUUBBUUK K RRAADDEEN N 00&&%%00""%%11&&&&" 2 ! " 2 ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22##8 8 !!220011001122$$001111110000''# # !!2200110011##1100$$&&11110000# # SSRRIIAASSIIH H GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&&&1 21 2$ $ S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22##& & !!220011001122$$00!!1111001100$ $ !!2200110011001100$$$$0000''22# # ((UUMMIINNI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&880 "0 "8 8 S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22!!0 0 !!220011001122$$00!!1111110000& & !!2200110011001100$$88001100008 8 NNAASSEERRI I GGUUBBUUK K RRAADDEEN N 0011%%00$$%%11&&880 "0 "$ $ S S L L DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22!!1 1 !!2200110011228800221111000000" " !!2200110011$$111122$$$$0000''! ! RRIINNAAYYUUN N GGUUBBUUK K RRAADDEEN N 00$$%%0011%%11&&$$$ #$ #1 1 S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00 22!!2 2 !!2200110011228800##11''000000' ' !!2200110011##1100$$&&""0000### # RRAAHHNNI I BBAAKKOONNG G DDAASSAAN N 00$$%%0011%%11&&&&" 2" 2! ! S S P P DDUUSSUUN N GGUUBBUUK K RRAADDEEN N 00000 0 00000 0 00