| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 1006 | - | ANDRI DESRI PALALLO | 30 Apr 2015, Thursday | VILLA MUKA KUNING BLOK D4 2 | 0823 8745 4362 | 0 |
| 1007 | - | SALMIAH BR NABABAN | 01 May 2015, Friday | LINGK IV KP LAMA | 0853 7456 1494 | 0 |
| 1008 | - | SURASAK KRAJOM | 05 May 2015, Tuesday | PERUM OMA GG 19 | 0812 7710 1082 | 0 |
| 1009 | - | MEME PUGEL | 11 May 2015, Monday | TG UMA | 0813 6147 120 | 0 |
| 1010 | - | WILLY | 12 May 2015, Tuesday | ANGGREK SARI BLOK F1 25 | 0819 9112 1648 | 0 |
| 1011 | - | DAMARIS LIBING DAWA | 25 May 2015, Monday | KP BELIMBING KEC BENGKONG | - | 0 |
| 1012 | - | SUJELI | 25 May 2015, Monday | JL KARTINI DABO SINGKEP | 0822 8569 1818 | 0 |
| 1013 | - | ERIYANTO | 30 May 2015, Saturday | BECERLY PARK 2 BLOK M3 | 0852 6486 1200 | 0 |
| 1014 | - | DARMAYANTI | 04 Jun 2015, Thursday | KALISARI PS REBO JAKARTA TIMUR | 0858 8346 2150 | 0 |
| 1015 | - | HOLITA | 04 Jun 2015, Thursday | BALOI KOLAM RT 7 RW 16 | 0853 6515 6261 | 0 |
| 1016 | - | KATRINA PARDEDE | 15 Jun 2015, Monday | TIBAN LAMA | 0823 8375 6609 | 0 |
| 1017 | - | JOHAN | 15 Jun 2015, Monday | PERUM CAHAYA GARDEN BLK G7 | 0852 7234 9568 | 0 |
| 1018 | - | ELIZABETH THEODORA HINGIR | 19 Jun 2015, Friday | BLOK II NAGOYA BATAM | 0812 7767 7707 | 0 |
| 1019 | - | ROSENTA PURNAMA SONDANG PURBA | 21 Jun 2015, Sunday | GRIYA BATU AJI ASRI U2 NO 25 | 0812 6892 4595 | 0 |
| 1020 | - | TUKMAIDA PASARIBU | 29 Jun 2015, Monday | GMP BLOK M1 | 0821 2129 9981 | 0 |