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<tr><td colspan="3" align="center"><font style="font-weight:bold; font-

size:16pt;">DATA CALON PESERTA DIDIK BARU TAHUN 2024</font></td></tr>
<tr><td colspan="3" align="center"><font style="font-weight:bold; font-
size:18pt;">PPDB MAN 2 Kota Sukabumi</font></td></tr>
<tr><td colspan="3" align="center"></td></td>
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Nomor Pendaftaran : <strong>MAN2S-67</strong><br>
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<tr bgcolor="yellow"><th>A</th><th>IDENTITAS CALON PESERTA DIDIK</th><th>
</th></tr>
</thead>

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<!--<tr><td>&nbsp;</td><td>NIS Lokal</td><td>Diisi Sekolah</td></tr>!-->

<tr><td>&nbsp;</td><td>NISN<br><small></small></td><td width="60%">: '000</td></tr>

<tr><td>&nbsp;</td><td>NIK<br><small></small></td><td width="60%">:
'3202296011090001</td></tr>

<tr><td>&nbsp;</td><td>Nama Lengkap</td><td>: BUNGA HANIFAH SYAHRANI</td></tr>

<tr><td>&nbsp;</td><td>Tempat Lahir</td><td>: SUKABUMI</td></tr>

<tr><td>&nbsp;</td><td>Tanggal Lahir</td><td>: 2009-11-20</td></tr>

<tr><td>&nbsp;</td><td>Jenis Kelamin</td><td>: Perempuan</td></tr>

<tr>
<td>&nbsp;</td>
<td>Agama</td>
<td>: </td>
</tr>
<tr>
<td>&nbsp;</td>
<td>Mapel yang disukai</td>
<td>: FISAKA,KIMIA</td>
</tr>
<tr><td>&nbsp;</td><td>Anak ke</td><td>: 2</td></tr>

<tr><td>&nbsp;</td><td>Status dalam Keluarga</td><td>: Anak Kandung</td></tr>

<tr><td>&nbsp;</td><td>Status Anak</td><td>: Bukan Yatim Piatu</td></tr>

<tr><td>&nbsp;</td><td>Jenis Kelamin</td><td>: Perempuan</td></tr>

<tr><td>&nbsp;</td><td>Telepon</td><td>: 083152619609</td></tr>

<tr><td>&nbsp;</td><td>Alamat calon peserta didik</td><td>: Jln.KP. CIBOLANG RT 025

RW 006</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kel.CIBATU</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kec.CISAAT</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kab./KotaSUKABUMI</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Prov.Jawa Barat</td></tr>

<tr bgcolor="yellow"><th>B</th><th>PENDIDIKAN SEBELUMNYA</th><th> </th></tr>

<tr><td>&nbsp;</td><td>Sekolah Asal</td><td>: MTs Swasta</td></tr>

<tr><td>&nbsp;</td><td>Nama Sekolah Asal</td><td>: MTSS MIFTAHUL HUDA</td></tr>
<tr><td>&nbsp;</td><td>Alamat Sekolah Asal</td><td>: KP. CIBOLANG</td></tr>

<tr bgcolor="yellow"><th>C</th><th>DATA ORANG TUA</th><th> </th></tr>

<tr><td>&nbsp;</td><td><b>Ayah</b></td><td></td></tr>
<tr><td>&nbsp;</td><td>Nama Ayah</td><td>: M DIDIN BURHANUDIN</td></tr>
<tr><td>&nbsp;</td><td>Telepon</td><td>: '085697522417</td></tr>
<tr><td>&nbsp;</td><td>Alamat</td><td>: jln. KP. CIBOLANG RT 025 RW 006</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kel.CIBATU</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kec.CISAAT</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kab./KotaSUKABUMI</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Prov.Jawa Barat</td></tr>

<tr><td>&nbsp;</td><td>Pekerjaan</td><td>: Swasta</td></tr>
<tr><td>&nbsp;</td><td>Agama</td><td>: Islam</td></tr>
<tr><td>&nbsp;</td><td>Kewarganegaraan</td><td>: WNI</td></tr>
<tr><td>&nbsp;</td><td>Pendidikan</td><td>: SLTP</td></tr>
<tr><td>&nbsp;</td><td>Penghasilan per bulan</td><td>: 1.000.000 -
2.500.000</td></tr>

<tr><td>&nbsp;</td><td><b>Ibu</b></td><td></td></tr>
<tr><td>&nbsp;</td><td>Nama Ibu</td><td>: NURHAYATI</td></tr>
<tr><td>&nbsp;</td><td>Telepon</td><td>: 085697522417</td></tr>
<tr><td>&nbsp;</td><td>Alamat</td><td>: jln. KP. CIBOLANG RT 25 RW 6</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kel.CIBATU</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kec.CISAAT</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kab./KotaSUKABUMI</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Prov.Jawa Barat</td></tr>

<tr><td>&nbsp;</td><td>Pekerjaan</td><td>: Ibu Rumah Tangga</td></tr>

<tr><td>&nbsp;</td><td>Agama</td><td>: Islam</td></tr>
<tr><td>&nbsp;</td><td>Kewarganegaraan</td><td>: WNI</td></tr>
<tr><td>&nbsp;</td><td>Pendidikan</td><td>: SD</td></tr>
<tr><td>&nbsp;</td><td>Penghasilan per bulan</td><td>: 1.000.000</td></tr>

<tr bgcolor="yellow"><th>D</th><th>DATA WALI</th><th> </th></tr>

<tr><td>&nbsp;</td><td>Nama Wali</td><td>: SDA</td></tr>
<tr><td>&nbsp;</td><td>Telepon</td><td>: </td></tr>
<tr><td>&nbsp;</td><td>Alamat</td><td>: jln. RT 0 RW 0</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kel.</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kec.</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Kab./Kota</td></tr>
<tr><td>&nbsp;</td><td></td><td>: Prov.</td></tr>

<tr><td>&nbsp;</td><td>Pekerjaan</td><td>: </td></tr>
<tr><td>&nbsp;</td><td>Agama</td><td>: </td></tr>
<tr><td>&nbsp;</td><td>Kewarganegaraan</td><td>: </td></tr>
<tr><td>&nbsp;</td><td>Pendidikan</td><td>: </td></tr>
<tr><td>&nbsp;</td><td>Penghasilan per bulan</td><td>: </td></tr>
<tr bgcolor="yellow"><th>E</th><th>KEJUARAAN YANG PERNAH DIRAIH</th><th> </th></tr>

<tr><td>&nbsp;</td><td>Tingkat Nasional</td><td></td></tr>
<tr><td></td><td></td><td></td></tr>
<tr><td>&nbsp;</td><td>Tingkat Provinsi</td><td></td></tr>
<tr><td></td><td></td><td></td></tr>
<tr><td>&nbsp;</td><td>Tingkat Kabupaten</td><td></td></tr>
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