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LAMPIRAN 1

FORMULIR REKAP USULAN SEKOLAH

DAFTAR SISWA MISKIN YANG DIUSULKAN SEKOALAH UNTUK MENDAPA

PERODE 2013 - 2014

B

NAMA SEKOALAH : SMKS KESEHATAN KOTA BAUBAU

NPSN : 40403152

ALAMAT : JL PALAGIMATA

KECAMATAN : BETOAMBARI

KABUPATEN/ KOTA : BAUBAU

PROVINSI : SULAWESI TENGGARA

NO. HP KEPALA SEKOLAH : 081524845753

 NO NISN NAMA SISWA JENIS KELAMIN

1 99657551560 1075381488 7472021602082970 Hayatun Nufus Perempuan

 NOMOR KARTUPERLINDUNAN SOSIAL

! KPS "

 NOMOR KARTUKELUARA

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 NAMA A#AH NAMA WALI

Haeruddin  

LI 2013

  AH

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  RSHAMSUL, SKM$, M$Ke%

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DAFTAR SISWA MISKIN BSM! YANG DIUSULKAN SEKOALAH UNT

PERIODE 2014-201"

NAMA SEKOLAH : SMKS KESEHATAN KOTA BAUBAUNPSN : 40403152

ALAMAT : JL. LAKARAMBAUKECAMATAN : BETOAMBARI

KABUPATEN/ KOTA : BAUBAUPROVINSI : SULAWESI TENGGARANO. HP KEPALA SEKOLAH : 081524845753

NO.

NISN

NAMA SISWA ! !"#AS $$#

1 9993630180 %A'&N&S # ( !")"*AWA$AN M"#AI+05 ,12,1999 SA#

2 14003 *"S$' AA*I& ) ( !")"*AWA$AN $IMI!A+ 25,07,1999 /AH

3 9983558926 H"*NIAN$I $AHI* ) ( !")"*AWA$AN !AISA%&+14,07,1999 HAS4 14006 N&* *"/!' AMA#IA ) ( !")"*AWA$AN NANA&MA#A+14,8,1998HA*

5 14009 S&$*'ANA NINSI ) ( !")"*AWA$AN !OM%A+3,6,1998 S&M

6 14004 HASNIA$I ) ( !")"*AWA$AN WA!ON$I+13,8,1999 A#IM

7 1080206008 HI!MA SA*IWAN ) (II !")"*AWA$AN %A&%A&+4,6,1997 *IW

8 1080206011 IWA'AN "*I! "%*IANA # (II !")"*AWA$AN AM%&A&+5,10,1996 NI!

9 9966876114 NOIAN$I ) (II !")"*AWA$AN SAMA*INA+2,11,1996 N&*

10 14010 AI#A ) ( !")"*AWA$AN #O#I%&+10,10,1999 N&*

11 9973990417 &SWA$&N HASANAH ) ( !")"*AWA$AN !"NA*I+1,11,1997 IS*A

12 1080206034 ) (II !")"*AWA$AN #A%A*AA+7,5,1997 WA

13 1080206038 *IO "%*IWAN !. # (II !")"*AWA$AN &AAN+1,3,1997 ANI

15 1080206048 WA SA*IANA ) (II A*MASI #O#I%&+29,3,1996 WA

16 N&*ANI WI AH'ANI # ( !")"*AWA$AN %A&%A& +19,6,1999 W

17 9963902600 #ISNAWA$I ) ( A*MASI MA#A'SIA++10,10,1996 SA*

18 9943494593 NA'IMA ) (II !")"*AWA$AN #I)& 12 7 1994 HIA

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22 9953695222 *INA#' '&IS$I*A # (II !")"*AWA$AN #AMANA+16,3,1997 *O

23 9983574764 N&* WAIAH ) ( A*MASI #IA%&!&+5,11,1999  '&

24 9993630919 )&)&$ )*A$IWI ) ( A*MASI %A&%A&+19,11,1999 S&

25 993619806 AH" *"/!I %"*#IAN ) ) (I !")"*AWA$AN WININ+1,1,1999 W

26 13020 ANISA *AHMANI HANI ) (I !")"*AWA$AN %A&%A&+19,4,1998 $IA

27 WAO" *&AIA ) (I A*MASI SO*ON+31,10,1998 #A

28 9952902014 SA*$I!A ) (II !")"*AWA$An A'A)&*A+1,1,1995 SIN

29 9963754125 N&* A*I ) (II A*MASI #AM%A#"+30,9,1996 WA

30 9973637610 A*$IA ) (II !")"*AWA$AN AM%ON+2,7,1998 HA

31 9963755725 MIAI # (II !")"*AWA$AN %A&%A&+26,1,1996 SA

32 9967436407 II A*IANI ) (II !")"*AWA$AN #O#I%&+14,12,1996 WA

33 9978472511 I*WI#'ANA I$*I'ANI .S ) (I !")"*AWA$AN %A&%A&+19,12,1998 HI

34 9983317429 INAH SA*I ) (I !")"*AWA$AN %A&%A&+1,10,1997 SA35 13009 S&WA*NI ) (I !")"*AWA$AN %A&%A&+14,6,1998 H

36 9983558551 AISA# # (I A*MASI !A*'A %A*&+11,3,1998 AS

38 9954886461 *A$I HASIM ) (I !")"*AWA$AN AM%ON+1,12,1995 A

39 9987813349 "#I*A HAMIS& ) ( A*MASI %A&%A&+1,10,1998 HA

40 9963755500 /&H*IA ) (II !")"*AWA$AN HA#MAH"*A+4,4,1997 WA

41 9983574019 NININ WAH'&NI ) (I ANA#IS !"S"HA$AN A

42 9983575473 AHMA M&NAWA* # (I ANA#IS !"S"HA$AN%AAIA+4,7,1998 I$

43 9973639020 *"NA#' '&IS$I*A # (I !")"*AWA$AN *O

44 1080206098 'IAN$I #"S$A*I ) (II A*MASI AM%ON+25,6,1997 SA

45 1080206099 M&*NI A'& ) (II A*MASI #O#I%&+21,7,1997 AS46 1080206100 IS$I )&*NAMA A*WI ) (II A*MASI S"*AM+3,2,1996 A

47 9983574525 #AO" AMIN NAWAWI # (I A*MASI I#I+6,5,1998 S*

48 9978270068 *"/A NINSIH ) (II !")"*AWA$AN )AN!A#A"*O+6,12,199 WA

49 1080206102 A'A ) (II !")"*AWA$AN WA$O*&M%"+1,4,1997 A

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53 13018 NOI MA*A*"$A ) (I !")"*AWA$AN %A&%A&+18,11,1998 O!

55 1080206106 SA*IA ) (I A*MASI #AM%A#"+27,12,1998 I*&

56 1080206108 MI*NA ) (I ANA#IS !"S"HA$AN$O#ANO+17,6,1997 SIH

57 1080206109 %AH* &M # (I !")"*AWA$AN &+12,12,1998 M&

58 1080206110 AI#A ) (I !")"*AWA$AN AM%ON+2,5,1998 WA

59 9966857523 A$MA !ASIM ) (I !")"*AWA$AN #I)&+14,4,1996 HA

60 9983558934 M"#A AN"#IA ) (I !")"*AWA$AN !AISA%& %A&+1,5,1998I W

61 9983574640  '&SNIA* ) (I !")"*AWA$AN #A%&AN$A"+4,3,1998 M&

62 1080206111 #A A*A # (I !")"*AWA$AN %AN$"A+4,4,1997 WA

63 13028 *IS!A *AMAANI ) (I !")"*AWA$AN WAO+7,6,1998 W

64 1080206113 IN*IANI ) (I !")"*AWA$AN AM%ON+3,9,1997 WA

65 1080206114 WAO" SI$I N&*AIA$ ) (I A*MASI AI*!AA"+23,1,1998 WA

66 1080206115 I*MAWA$I ) (I A*MASI %A&%A&+17,11,1997 S&67 1080206116 W"N' )&*NAMA SA*I ) (I ANA#IS !"S"HA$AN%A&%A&+1,10,1997 MA

68 1080206117 ISWA$I ) (I A*MASI #A%"#"NA+16,6,1998 *&

69 9983574976 N&*ANA ) (I A*MASI WAM"O+29,12,1998 WA

70 1080206118 A!' N.. $I"#&N # (I ANA#IS !"S"HA$AN!"NA*I+30,11,1998 N&

71 1080206119 SI$I AS*IANI ) (I ANA#IS !"S"HA$AN)&MA+8,12,1997 MI

72 1080206120 IIN WAHINI ) (I A*MASI $IMI!A+8,12,1998 /&

73 1080206121 SI NA*NI ) (I ANA#IS !"S"HA$AN$O#ANO+18,5,1997 SI

74 9983574019 NININ WAH'&NI ) (I ANA#IS !"S"HA$ANAM%ON+16,12,1998

75 1080206123 M"A A)*I#IA ) (I A*MASI AM%ON+24,4,1998 AIS

76 9983912427 NI/*A ) (I A*MASI %A&%A&+9,3,1998 HA77 1080206124 /&!IA M&S$AA ) (I !")"*AWA$AN #IW&$O+31,7,1996 /&

78 1080206125 W. NI*A'AN S&*I ) (I !")"*AWA$AN %AHA*I+7,6,1999 IA

79 1080206126 A ) (I !")"*AWA$AN AM%ON+2,4,1996 *&

80 1080206127 I*NAWA$I ) (I !")"*AWA$AN WA!AO!I#I+19,7,1998 NI

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!eteranan

1 erasa: dari ;e:uara ?ara atauisa:nya sis@a denan ;e:ainan Bsi;+ ;=ran enana er;ee>i:i;i 3 saudara a

BAU

KEPA

MAR

NI' 1

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*ANS#INI. $ 1

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