| NO. | FORMULIR | NAMA LENGKAP | TANGGAL MASUK ISLAM | ALAMAT | TELEPON | SURAT KETERANGAN |
|---|---|---|---|---|---|---|
| 1171 | - | MARIA DENSI TANA DAFITA | 18 Apr 2015, Saturday | BUKIT TIMUR | 0812 8066 824 | 0 |
| 1172 | - | RONY BRAHMANA | 27 Mar 2015, Friday | BLK 2 WINDSOR | 0812 6830 0326 | 0 |
| 1173 | - | NANG NON | 15 May 2015, Friday | CITRA KOTA MAS B1/26 | 0822 4429 3209 | 0 |
| 1174 | - | YUGI FIRMANTA | 20 Jun 2015, Saturday | GRIYA BATU AHI BLKE/5 | 0821 2727 54219 | 0 |
| 1175 | - | DEASY ARISANDI MANIK | 03 Jun 2015, Wednesday | BOTANIA GATRDEN | 0823 6165 1848 | 0 |
| 1176 | - | HERI WAGUNG | 15 Jun 2015, Monday | SUNGAI TONGKANG | 0823 8933 0245 | 0 |
| 1177 | - | VAJAR SUNARDI SIAHAAN | 20 Jun 2015, Saturday | KP PELANDUK BT AJI | 0821 6905 1491 | 0 |
| 1178 | - | MARIANA SIMANJUNTAK | 05 Jan 2016, Tuesday | TJ PIAYU | - | 0 |
| 1179 | - | FRANCISCUS RUDI WAHYUDI | 05 Jan 2016, Tuesday | FAMILY DREAM BANDARA B3/2 | 0812 7753 0009 | 0 |
| 1180 | - | SANTIKA MARPAUNG | 05 Jan 2016, Tuesday | BENGKONG INDAH BLK E/22 | 0822 8550 7851 | 0 |
| 1181 | - | ROSDIANA SINAGA | 10 Jan 2016, Sunday | LEGENDA MALAKA BLK H9/9 | 0813 0460 1021 | 0 |
| 1182 | - | SYAHPRIDA FITRI | 10 Jan 2016, Sunday | BELAKANG PADANG | 0812 7005 3600 | 0 |
| 1183 | - | R AGUNG KUNTADI HENDRAWAN | 11 Jan 2016, Monday | PULAU ABANG | 0812 6858 4323 | 0 |
| 1184 | - | FENDI SITUMEANG | 20 Jan 2016, Wednesday | WARTA KARSA FF6 | 0812 6841 2544 | 0 |
| 1185 | - | THANDAYUTHAM NEELAGHIRI | 25 Jan 2016, Monday | BLK 37 CICUIT ROAD SINGPORE | 0659 8953 100 | 0 |