Nomor Statistik RA
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DAFTAR CALON ANAK DIDIK BARU
RA ........................................
TAHUN PELAJARAN
:........................./…………………..
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No Urut
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Nama Anak
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Jenis Kelamin
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Tempat Tanggal Lahir
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Nama Orang Tua/Wali
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Alamat Tempat Tinggal
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Keputusan
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Ket
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L
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P
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Diterima
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Ditolak
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(1)
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(2)
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(3)
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(4)
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(5)
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(6)
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(7)
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(8)
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(9)
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(10)
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