| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 781 | - | RONY | 08 Oct 2012, Monday | SUNGAI PANCUR BLOK C NO 10 | 0852 7437 8856 | 0 |
| 782 | - | MARSELA PARMININGSIH | 11 Oct 2012, Thursday | TAMAN RAYA BLOKKK GN NO 24 | 0812 8167 9806 | 0 |
| 783 | - | SITI DJUBAEDAH | 14 Oct 2012, Sunday | KAYURINGIN BEKASI TIMUR | 0821 1298 8781 | 0 |
| 784 | - | MARGARETH CAROLINE DEBORAH NATALIE | 19 Oct 2012, Friday | BALOI MAS INDAH L 5A | 0812 7720 8588 | 0 |
| 785 | - | MICHAEL DANIEL NENDRA | 06 Nov 2012, Tuesday | SUNGAI PANAS NO 36 | 0856 6842 5894 | 0 |
| 786 | - | KETUT PRIYANTO | 16 Nov 2012, Friday | REJOMULYO SUGIWARAS JATIM | 0812 5924 4458 | 0 |
| 787 | - | SANDRATAN | 27 Nov 2012, Tuesday | JL. PENGARAM NO 4 SLT PANJANG | 0813 7210 8129 | 0 |
| 788 | - | IMANUEL SUENAUNG | 04 Dec 2012, Tuesday | BUANA IMPIAN II BLOK G18 | 0812 7077 9117 | 0 |
| 789 | - | WIDYATIKA RINI | 08 Dec 2012, Saturday | KP BELIAN RT2/2 | 0813 7271 6319 | 0 |
| 790 | - | STEPHANIE | 12 Dec 2012, Wednesday | BALOI MAS INDAH BLOK B 15 | 0812 7079 0257 | 0 |
| 791 | - | JOJOR ZENDRATO | 14 Dec 2012, Friday | SP RUKO BATUAJI | 0823 8982 2323 | 0 |
| 792 | - | RESTON DAVID | 20 Dec 2012, Thursday | MANGSANG PERMAI BLOK E 1/2 | 0856 6545 198 | 0 |
| 793 | - | STEPHANUS ANDY HERMAWAN | 22 Dec 2012, Saturday | CIKITSU BLOK B1 BATAM CENTER | 0877 9122 9322 | 0 |
| 794 | - | WENS LAUS WATU | 23 Dec 2012, Sunday | KAMPUNG NANAS | 0821 7158 2131 | 0 |
| 795 | - | GABRIEL AUDYA CITRA | 08 Jul 2013, Monday | BENGKONG HARAPAN | 0856 6829 2003 | 0 |