| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 1126 | - | SATRIA FERNANDO | 29 Jul 2015, Wednesday | BENGKONG SWADAYA | 0857 6524 3659 | 0 |
| 1127 | - | BENSON BIN MIAU | 24 Aug 2015, Monday | - | - | 0 |
| 1128 | - | HERY YENCE | 25 Aug 2015, Tuesday | BALOI VILA NO. 5 | 0852 7288 8663 | 0 |
| 1129 | - | EDUARDIE | 28 Aug 2015, Friday | VILLA MELATI MAS BLOK G7 19 | 0813 1016 2008 | 0 |
| 1130 | - | HERYANTO PURBA | 31 Aug 2015, Monday | BIDA ASRI 1 BATAM CENTER | 0812 6111 0982 | 0 |
| 1131 | - | CAHAYA SIAHAAN | 07 Sep 2015, Monday | KOMP DITPAM BLOK I 4 | 0852 0540 3703 | 0 |
| 1132 | - | RAMANITHARA SHANMUGAM | 09 Sep 2015, Wednesday | NONGSA VILLA TELUK MAJA | 0811 7718 825 | 0 |
| 1133 | - | AWAN WIJAYANTO | 11 Sep 2015, Friday | SINGOSARI KEPATIHAN MADIUN | 0857 7604 7771 | 0 |
| 1134 | - | ENDANG PRIANTI | 28 Sep 2015, Monday | GREEN LANE | 0819 0811 9021 | 0 |
| 1135 | - | LUSIA LONGA | 15 Oct 2015, Thursday | BUKIT SENYUM RT 4 RW 7 | - | 0 |
| 1136 | - | IIN SULAINI | 24 Oct 2015, Saturday | ARMENDO RAYA D NO 3 | 0822 8434 8881 | 0 |
| 1137 | - | LISDA MARIDA SIHOTANG | 03 Nov 2015, Tuesday | BENGKONG SARMEN G 27 | 0852 7217 1498 | 0 |
| 1138 | - | ANNA SISILIA SIREGAR | 05 Nov 2015, Thursday | GREENLAND BLOK F1 NO 10 | 0852 1881 4691 | 0 |
| 1139 | - | JHONIANTO PASARIBU | 07 Dec 2015, Monday | MARINDAL | 0812 7032 2869 | 0 |
| 1140 | - | PATHIPATI LOKESH | 08 Dec 2015, Tuesday | DUTAMASVICTORIA CLUSTER 2 | 0812 6829 0433 | 0 |