| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 1411 | - | KENNY YORI HERMAN | 28 Oct 2019, Monday | PIAYU PINTU 3, BLOK Z1, NO.24 | 0822 6828 5697 | 0 |
| 1412 | - | BATONIA SEPRIANDI | 08 Nov 2019, Friday | JLN. PELITA VII, KOMP. PELITA MAS BLOK HH NO.06 | 0812 6193 2114 | 0 |
| 1413 | - | WINDA MEI NATHALIA BR GIRSANG | 22 Nov 2019, Friday | PERUMAHAN ODESSA BLOK C18 NO 20 | 0813 7585 0731 | 0 |
| 1414 | - | JANNES SUDUNG HASIHOLAN | 06 Dec 2019, Friday | JL. PARKIT 9 NO.8, KDA | 0813 6360 4443 | 0 |
| 1415 | - | YEREMIAS WATI | 26 Dec 2019, Thursday | KAMPUNG NANAS, RT.04 RW.12 | 0813 6334 4148 | 0 |
| 1416 | - | FROLINSIA JOHAN | 30 Dec 2019, Monday | KOMP. ANGGREK SARI BLOK G NO.17 | 0812 7002 6229 | 0 |