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Formulir Keterangan Tidak Mampu
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Nama
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Tempat Lahir
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Tanggal Lahir
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DD
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Jenis Kelamin
Laki-Laki
Perempuan
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Alamat (RT, RW, Desa)
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Nama Kepala Keluarga
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Pekerjaan Kepala Keluarga
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Hubungan Dalam Keluarga (ex: Isteri, anak)
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Alamat Kepala Keluarga (RT, RW, Desa)
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Keperluan (ex: Keringanan Biaya Sekolah)
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