Page 4 - TATIB SANETA 6
P. 4
Buku Panduan Peserta Didik MTsN 6 Tangerang
IDENTITAS PESERTA DIDIK
Nama Peserta didik : ..............................................................................................
NISM / NISN : ..............................................................................................
Tempat / tanggal Lahir : ..............................................................................................
Jenis Kelamin : ..............................................................................................
Alamat Peserta didik : ..............................................................................................
: ..............................................................................................
Desa /Kelurahan : ..............................................................................................
Kecamatan : ..............................................................................................
Kabupaten dan Provinsi : ..............................................................................................
Nama Orang Tua / Wali : ..............................................................................................
Pekerjaan : ..............................................................................................
Alamat : ..............................................................................................
: ..............................................................................................
No.Telp./Hp. : ..............................................................................................
Teluknaga, .............................2023
( ..................................................... )
iii
