| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 436 | - | STEVEN WIJAYA | 22 Nov 2011, Tuesday | KAMPUNG SERAYA 003/001 | 0853 6456 8368 | 0 |
| 437 | - | GUSTI NENGAH EKA MUDIANSI | 22 Nov 2011, Tuesday | PASAR PELITA | 0812 7092 5561 | 0 |
| 438 | - | ELLY RIANATA HUTABARAT | 02 Jan 2012, Monday | TEMBESI CENTER BLOK A11 8 | 0813 7284 4784 | 0 |
| 439 | - | JUNI DARWATI LAOLY | 17 Jan 2012, Tuesday | TAMAN RAYA TAHAP II BLOK DP 3 | 0812 1737 61590 | 0 |
| 440 | - | SEBASTIAN LOBI | 30 Jan 2012, Monday | SIMPANG DAM | - | 0 |
| 441 | - | THOMAS | 13 Feb 2012, Monday | BUKIT TEMPAYAN BATUAJI | - | 0 |
| 442 | - | TUTIANA | 23 Feb 2012, Thursday | PONDOK AWAL INDAH BLOK C 10 | 0813 6467 1110 | 0 |
| 443 | - | SARIMAN | 23 Feb 2012, Thursday | BATAM CENTER PARK BLOK F 8 | 0813 9227 5776 | 0 |
| 444 | - | DEASY RATNA SARI | 28 Feb 2012, Tuesday | JODOH SQUARE BLOK E 61 | 0857 3037 7785 | 0 |
| 445 | - | HERMAN ZEBUA | 29 Feb 2012, Wednesday | DIAMOND PALACE BLOK D NO 6 | 0812 7016 6580 | 0 |
| 446 | - | ADIMAS DAMAR PRADITYA | 29 Feb 2012, Wednesday | KAMPUNG P ELITA LUBUK BAJA | 0856 6844 5542 | 0 |
| 447 | - | HILDA DAME ULINA PANGARIBUAN | 20 Mar 2012, Tuesday | PERUM PENDAWA ASRI BLOK F1 15 | 0857 6127 7919 | 0 |
| 448 | - | ERICH LYNN HORN | 06 Apr 2012, Friday | 530 24TH #110 OAKLAND USA | - | 0 |
| 449 | - | SITI NURBAYA | 07 Apr 2012, Saturday | BENGKONG | 0821 6967 6833 | 0 |
| 450 | - | MONIKA MONE | 10 May 2012, Thursday | TANJUNG UMA 05/06 | 0812 6644 7382 | 0 |