Lembar Serah Terima.docx
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LEMBAR SERAH TERIMA KTP/CARD BPJS/KIA/…………… Yang bertanda tangan dibawah ini saya: Nama : Umur : Alamat : Menyatakan dengan sebenarnya bahwa saya telah menerima kartu tersebut diatas.
Srono, ………..
Petugas
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Srono, ………..
Petugas
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