BUKU INDUK

1. No. Induk Santri : _____________________
A. KETERANGAN SANTRI
1. Nama Santri Lengkap : .....................................................................................
2. Nama Panggilan : .....................................................................................
3. Tempat/Tgl Lahir : .....................................................................................
4. Jenis Kelamin : L/P
5. Jumlah Saudara : ....................anak ke ...................................................
6. Alamat : .....................................................................................
B. KETERANGAN ORANG TUA
1. Nama Orang Tua
a. Ayah : .....................................................................................
b. Ibu : .....................................................................................
2. Pendidikan
a. Ayah : .....................................................................................
b. Ibu : .....................................................................................
3. Pekerjaan
a. Ayah : .....................................................................................
b. Ibu : .....................................................................................
4. Alamat Orang Tua : .....................................................................................
No. Telpon : ................................... Hp............................................
C. KETERANGAN WALI
1. Nama Wali : .....................................................................................
2. Alamat Wali : .....................................................................................
No. Telpon : ................................... Hp............................................
3. Hub. Dengan Anak : a. Kakek b. Nenek c. Paman
d. Lainnya. Sebutkan ..................................................
D. PERKEMBANGAN SANTRI
1. Khotam Al-Qur’an/Tidak Khotam:
a. Tanggal : .....................................................................................
b. Syahadah No. : .....................................................................................
2. Melanjutkan ke
a. Madin : .....................................................................................
b. Ponpes : .....................................................................................
c. Lainnya : .....................................................................................