PRIMARY REPORT

CHALIDANA ISLAMIC SCHOOL

Confiden . Innovative . Smar
t t

Name:

ARORA

Puri Safira Regency K3/20 – Gresik, East Java - Indonesia

Phone +6281231113232, Email: info@chalidanaislamicschool.sch.id

www.chalidanaislamicschool.sch.id
INSTRUCTION

1. This Student Learning Outcomes Report is a summary of the results of the assessment
of all learning activities carried out by students within a certain period of time. Reports
on the progress and learning outcomes of students in detail, are presented in a portfolio
which is an integral part of this Student Learning Outcomes Report;
2. This Student Learning Outcomes Report contains general motivations as a self-image
of student behaviour as a whole (holistic) that reflects spiritual attitudes, social attitudes,
knowledge, and skills. 
3. This Student Learning Outcome Report is used as long as the student concerned
attends lessons in elementary school;
4. When changing schools, this Student Learning Outcome Report is brought by the
student concerned to be used in the new school by leaving the archive/copy at the old
school;
5. If this Learner Learning Outcome Report book is lost, it can be replaced with a
replacement Learner Learning Outcome Report Book certified by the original Principal;
6. The assessment report contains learning outcomes that are presented quantitatively
and descriptively for each competency.
7. Quantitative Value Description
Quantitative scores with a scale of 1 – 4 (applicable multiples of 0.33) are used for
Knowledge Values (KI 3) and Skills Values (KI 4). Quantitative Value Index with a Scale
of 1 - 4 and 0 - 100 are:

Final Value Conversion Predicate

Attitude Classification
(Knowledge and
0 - 100 Scale Scale 1 - 4 and Extracurricular
Skills)
86 -100 4 A
SB
81- 85 3.66 A-
76 – 80 3.33 B+
71-75 3.00 B B
66-70 2.66 B-
61-65 2.33 C+
56-60 2 C C
51-55 1.66 C-
46-50 1.33 D+
K
0-45 1 D

DESCRIPTION OF QUALITATIVE VALUE

The qualitative value used for the value of spiritual attitudes (KI 1), 
and social attitudes (KI 2), as well as extracurricular activities, are 
    SB   = Very good  
      B   = Well  
      C   = Enough 
      K   = Not enough
8. Student self-records, physical/health are filled with quantitative data based on the
results of measurements made by teachers and students or other relevant parties.
9. The record of the student's health condition is filled with a description of the results of
the examination carried out by the teacher or other relevant parties.
10. The absence column is filled with data on the accumulation of student absences, either
due to illness, permission, or without information in one semester.
 STUDENT’S IDENTITY

Student’s Name : ...............................................................................................

Student Number : ...............................................................................................
Date of Birth : ...............................................................................................
Gender : ...............................................................................................
Religion : ...............................................................................................
Previous School : ...............................................................................................
Student’s Address : ...............................................................................................
Parents’ Name
Father : ...............................................................................................
Mother : ...............................................................................................
Parents’ Occupation
Father : ...............................................................................................
Mother : ...............................................................................................
Parents’ Address
Road : ...............................................................................................
Village : ...............................................................................................
District : ...............................................................................................
County/City : ...............................................................................................
Province : ...............................................................................................
Student’s Guardian
Name : ...............................................................................................
Occupation : ...............................................................................................
Address : ...............................................................................................

........................, …………………………
Primary Principal,

Passport
photo
3x4

NIY.
 STUDENT’S REPORT AND IDENTITY

Student’s Name : ................................ Grade : ...................

Student Number : ................................ Semester : ...................
School : ................................ School Year : ...................
School’s Address : ................................

A. Attitude

Description

Spiritual Attitude Arora taat beribadah, berperilaku syukur, selalu berdoa

sebelum melakukan kegiatan dan sudah mampu meningkatkan
sikap toleransi beragama.
Social Attitude Arora sangat jujur, percaya diri dan sudah mampu
meningkatkan sikap disiplin.

B. Knowledge and Skill

Passing Grade: 73

Knowledge Skill
No Subejct
Mark Predicate Description Mark Predicate Description

Pendidikan
1. Agama dan
Budi Pekerti

Pendidikan
Pancasila
2.
dan
Kewarganeg
araan
3. Bahasa 81 B Ananda 85 B Ananda Arora
Indonesia Arora sangat baik
sangat baik dalam
dalam mempraktikka
mengenal n kegiatan
kosakata persiapan
tentang cara membaca
memelihara permulaan,
kesehatan cukup dalam
melalui melafalkan
tes
pendek,
 cukup dalam bunyi vokal
menguraika dan
n lambang konsonan.
bunyi vocal
dan
konsonan

4. Matematika

Ilmu
5. pengetahua
n alam

Ilmu
6. pengetahua
n sosial

Seni budaya
7. dan
keterampilan

Pendidikan
8. Jasmani,
Olahraga
dan
Kesehatan
9. Muatan lokal

a. ..................

b. ..................

c. ..................
C. Extracurricular

No Extracurricular Program Remark

Arora sebagai ketua regu dalam
1. Praja Muda Karana (Pramuka) kegiatan Pramuka.

3. ....................................................... ......................................

D. Teacher’s Note

Arora Shows respect for peers and teachers. Also, Arora is a leader and positive role
model for students. However, she needs frequent reminders to stay focused
throughout the day.

E. Height and Weight

Semester
No Aspect
1 2
1. Height

2. Weight

F. Health Condition

No Aspect Note

1. Hearing Baik

2. Vision Baik

3. Others ....................
G. Achievement

No Achievement Note

1. Arts

2. Sports

3. Other ................... .

H. Attendance

Sick : ......................

Permit : ......................

Absent : ......................

Acknowledged by ......................, ............................ 2021

Parent/Guardian Teacher

Acknowledged by
Principal