| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 1051 | - | RIANA LIU | 18 Jun 2015, Thursday | CITY GARDEN BLK RAYA /12-14 | - | 0 |
| 1052 | - | JHON CLINTON JUDE DE SILVA | 16 Oct 2015, Friday | KAMP. KAMBOJA TG UBAN | 0812 6163 2900 | 0 |
| 1053 | - | SRI VERA SAODAH | 12 Mar 2015, Thursday | BALOI DITPAM | 0821 7043 3226 | 0 |
| 1054 | - | EVA WATI TAMPUBOLON | 12 Apr 2015, Sunday | BATU AJI | 0856 6586 514 | 0 |
| 1055 | - | FRANS JHONATAN MARPAUNG | 14 Aug 2015, Friday | JL MELUR | 0812 6862 8854 | 0 |
| 1056 | - | ERNAWATI BR SITORUS | 16 Aug 2015, Sunday | DUSUN SAPTA MARGA | 0813 7572 6017 | 0 |
| 1057 | - | WIDI ASTUTI | 07 Aug 2015, Friday | BIDA KABIL | 0852 6840 1978 | 0 |
| 1058 | - | SARMIAH | 06 Aug 2015, Thursday | BLOK 2 | 0822 8551 0985 | 0 |
| 1059 | - | HERLINA SARI DEWI PASARIBU | 11 Aug 2015, Tuesday | BATAM CENTER | 0813 7249 7439 | 0 |
| 1060 | - | WIWIK KARTINA | 18 Dec 2015, Friday | KAMPUNG SERAYA 004/002 | 0895 3304 86657 | 0 |
| 1061 | - | SINTA | 12 Oct 2015, Monday | JL CEMARA PALUA | 0812 9050 2000 | 0 |
| 1062 | - | ANGELINA DEWI | 13 Jul 2015, Monday | LEGENDA MALAKA | 0812 6193 2899 | 0 |
| 1063 | - | MICHAEL | 24 Jul 2015, Friday | JL DANAU JEMPANG | 0853 5977 1514 | 0 |
| 1064 | - | YUSTINUS DEWANTORO | 13 Jul 2015, Monday | LEGENDA MALAKA | 0852 8041 094 | 0 |
| 1065 | - | LIZA DINI ESTER | 13 Aug 2015, Thursday | PEMDA 2 PERUM SAWANGAN PERMAI | 0822 3632 0334 | 0 |