| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 721 | - | SARLINA PASARIBU | 31 May 2011, Tuesday | KAMPUNG BARU CENDANA 2 | - | 0 |
| 722 | - | MELAWATI TIUR METOA | 08 Aug 2011, Monday | TJ UBAN SELATAN BINTAN UTARA | 0813 7280 1128 | 0 |
| 723 | - | SUSI MINARTI | 22 Apr 2011, Friday | YOS SUDARSO 002/001 TJ UBAN | 0856 6513 792 | 0 |
| 724 | - | LISMAWATI SIAGIAN | 21 Mar 2011, Monday | BALOI DITPAM | 0813 6425 8134 | 0 |
| 725 | - | SUSANT MANDUAPESSY | 13 May 2011, Friday | SAPARUA MALUKU TENGAH | 0821 7123 1528 | 0 |
| 726 | - | ANDY WILLIAM | 14 Aug 2011, Sunday | VILLA PESONA ASRI A10/12 | 0831 8426 0594 | 0 |
| 727 | - | MELANI SURANTO | 17 Aug 2011, Wednesday | SUNGAI PANCUR E/35 | 0821 7156 3205 | 0 |
| 728 | - | IGNASIUS WANGGE | 21 Nov 2011, Monday | PENGAIRAN LAMA 004/04 | 0821 7439 1611 | 0 |
| 729 | - | SURIANI SILALAHI | 07 Feb 2011, Monday | CENDANA 003/004 | 0813 6467 8113 | 0 |
| 730 | - | FILEMON BAYEN PEKA | 24 May 2011, Tuesday | KAMPUNG PANAU NONGSA | 0812 7755 2643 | 0 |
| 731 | - | DAVID DAUD SIREGAR | 14 Feb 2011, Monday | P SIDEMPUAN | - | 0 |
| 732 | - | CENDRA AGUSTINA | 06 Feb 2011, Sunday | NAGOYA CITY CENTER C10 | 0813 7228 5029 | 0 |
| 733 | - | DIEDERIK ALEXANDER (CYRIEL) PETER W | 06 Feb 2011, Sunday | APARTEMEN LAI LAI NAGOYA | 0081 3 64 81508 | 0 |
| 734 | - | ENY FARIDA SIHOMBING | 31 May 2011, Tuesday | KAV. BARU CENDANA 2 /1 KABIL | 0821 7131 5951 | 0 |
| 735 | - | THO LIANG | 11 Jan 2011, Tuesday | BUKIT JODOH 1/7B | 0819 9081 9494 | 0 |