| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 76 | - | ALI | 01 Oct 2005, Saturday | DURI MALAKA 110 SEKUPANG | 0812 7033 849 | 0 |
| 77 | - | DENY CHRISLAYANTO | 05 Oct 2005, Wednesday | TAMAN YASMIN O/10 | 0813 7200 6401 | 0 |
| 78 | - | SUKARIA GINTING | 08 Oct 2005, Saturday | BIDA ASRI 2 G2/1 BATAM CENTER | 0813 6400 3897 | 0 |
| 79 | - | JELITA HUTABALIAN | 12 Oct 2005, Wednesday | - | - | 0 |
| 80 | - | FAERENCIA MONIAGA | 13 Oct 2005, Thursday | VILLA PESONA ASRI | - | 0 |
| 81 | - | IKARASANTI SIDABUKKE | 29 Oct 2005, Saturday | GMP O/16 TJ PIAYU | 0815 3603 1111 | 0 |
| 82 | - | DELVI AGUSTINE BUNOCH | 10 Nov 2005, Thursday | BENGKONG TENGAH O/24A | 0856 6809 0353 | 0 |
| 83 | - | SARMIDA SIDAURUK | 10 Nov 2005, Thursday | CENTER POINT | - | 0 |
| 84 | - | EVA SIMANJUNTAK | 25 Nov 2005, Friday | BELAKANG BEBEK BALI | 0813 7211 9610 | 0 |
| 85 | - | CHEAH KIM CHONG | 13 Dec 2005, Tuesday | BLK 356C#11-118 ADMIRALTY DRIVE SINGPORE | 0916 3401 3 | 0 |
| 86 | - | DEA ASRI YANTI | 16 Dec 2005, Friday | TAMAN DUTA MAS A17/8 | 0778 4623 38 | 0 |
| 87 | - | AGUS RISANTI | 18 Dec 2005, Sunday | MESS PLANET HOLIDAY | 0856 6605 543 | 0 |
| 88 | - | CIN HAN | 18 Dec 2005, Sunday | ANGGREK SARI | - | 0 |
| 89 | - | SIAT SAN | 25 Dec 2005, Sunday | PONDOK ASRI INDAH | 0812 7777 055 | 0 |
| 90 | - | JENLY SOFIA | 27 Dec 2005, Tuesday | - | - | 0 |