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    1. This document is a family card for Supono who lives in Kalitinggar village. It lists Supono as the head of household along with his wife, two children, their dates of birth, religions, occupations, and parental information. 2. The family card provides details such as the names, identification numbers, dates of birth, occupations for Supono, his wife Warsinah, and their two children Fadhilah Saputri and Dani Agus Setiawan. 3. The document was issued on October 12, 2021 and contains the signatures of Supono as head of household and the head of population and civil registration office.

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    Untitled2

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    1. This document is a family card for Supono who lives in Kalitinggar village. It lists Supono as the head of household along with his wife, two children, their dates of birth, religions, occupations, and parental information. 2. The family card provides details such as the names, identification numbers, dates of birth, occupations for Supono, his wife Warsinah, and their two children Fadhilah Saputri and Dani Agus Setiawan. 3. The document was issued on October 12, 2021 and contains the signatures of Supono as head of household and the head of population and civil registration office.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    8 views1 page

    Untitled 2

    Uploaded by

    Abdi Najarudin
    1. This document is a family card for Supono who lives in Kalitinggar village. It lists Supono as the head of household along with his wife, two children, their dates of birth, religions, occupations, and parental information. 2. The family card provides details such as the names, identification numbers, dates of birth, occupations for Supono, his wife Warsinah, and their two children Fadhilah Saputri and Dani Agus Setiawan. 3. The document was issued on October 12, 2021 and contains the signatures of Supono as head of household and the head of population and civil registration office.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 1

    KARTU KELUARGA

    No.3303151001120001
    Nama Kepala Keluarga : SUPONO Desa/Kelurahan : KALITINGGAR
    Alamat : KALITINGGAR DUSUN. KALITINGGAR Kecamatan : PADAMARA
    RT/RW : 002/003 Kabupaten/Kota : PURBALINGGA
    Kode Pos : Provinsi : JAWA TENGAH
    Jenis Tanggal Golongan
    No Nama Lengkap NIK Tempat Lahir Agama Pendidikan Jenis Pekerjaan
    Kelamin Lahir Darah
    (1) (2) (3) (4) (5) (6) (7) (8) (9)
    1 SUPONO 3303152207750001 LAKI-LAKI PURBALINGGA 22-07-1975 ISLAM TAMAT SD/SEDERAJAT BURUH HARIAN LEPAS TIDAK TAHU

    2 WARSINAH 3303155212820001 PEREMPUAN PURBALINGGA 12-12-1982 ISLAM TAMAT SD/SEDERAJAT BURUH HARIAN LEPAS TIDAK TAHU

    3 FADHILAH SAPUTRI 3303156510070003 PEREMPUAN PURBALINGGA 23-10-2007 ISLAM TAMAT SD/SEDERAJAT PELAJAR/MAHASISWA TIDAK TAHU

    4 DANI AGUS SETIAWAN 3303150108160001 LAKI-LAKI PURBALINGGA 01-08-2016 ISLAM BELUM TAMAT SD/SEDERAJAT PELAJAR/MAHASISWA TIDAK TAHU

    5 - - - - - - - - -
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    Status Tanggal Status Hubungan Dokumen Imigrasi Nama Orang Tua


    No. Kewarganegaraan
    Perkawinan Perkawinan Dalam Keluarga No. Paspor No. KITAP Ayah Ibu
    (10) (11) (12) (13) (14) (15) (16) (17)
    1 KAWIN TERCATAT 03-08-2006 KEPALA KELUARGA WNI - - RUHENI SUKENI
    2 KAWIN TERCATAT 03-08-2006 ISTRI WNI - - SANDIWIRYA TARSINAH
    3 BELUM KAWIN - ANAK WNI - - SUPONO WARSINAH
    4 BELUM KAWIN - ANAK WNI - - SUPONO WARSINAH
    5 - - - - - - - -
    6 - - - - - - - -
    7 - - - - - - - -
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    9 - - - - - - - -
    10 - - - - - - - -

    Dikeluarkan Tanggal : 12-10-2021 KEPALA KELUARGA KEPALA DINAS KEPENDUDUKAN


    DAN PENCATATAN SIPIL
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    SUPONO Drs. MUHAMMAD FATHURROHMAN, M. Si


    Tanda Tangan/Cap Jempol NIP. 196710071993031005
    Dokumen ini telah ditandatangani secara elektronik menggunakan sertifikat elektronik yang diterbitkan oleh Balai Sertifikasi Elektronik (BSrE), BSSN

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