| No | Nama Lengkap | NIK | Jenis Kelamin | Tempat Lahir | Tanggal Lahir | Agama | Pendidikan | Jenis Pekerjaan |
|---|---|---|---|---|---|---|---|---|
| (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | |
| 1 | Naufal Akbar Nugroho | 1234567890 | Laki-laki | Malang, Jawa Timur | 15-07-2004 | Islam | S1 | PNS |
| 2 | Salsabila Adisty Cantika | 1234567890 | Perempuan | Malang, Jawa Timur | 23-01-2005 | Islam | S1 | PNS |
| 3 | Sebastian Bagus Nugroho | 1234567890 | Laki-laki | Malang, Jawa Timur | 16-05-2010 | Islam | SMP / Sederajat | Pelajar |
| 4 | Salsabila Cantika Purnama | 1234567890 | Perempuan | Malang, Jawa Timur | 20-01-2015 | Islam | SD / Sederajat | Pelajar |
| 5 | - | - | - | - | - | - | - | - |
| 6 | - | - | - | - | - | - | - | - |
| 7 | - | - | - | - | - | - | - | - |
| 8 | - | - | - | - | - | - | - | - |
| 9 | - | - | - | - | - | - | - | - |
| 10 | - | - | - | - | - | - | - | - |
| No | Status Perkawinan | Status Hubungan Dalam Keluarga | Kewarganegaraan | Dokumen Imigrasi | Nama Orang Tua | ||
|---|---|---|---|---|---|---|---|
| No.Paspor | No. KITAP | Ayah | Ibu | ||||
| (09) | (10) | (11) | (12) | (13) | (14) | (15) | |
| 1 | Kawin | Kepala Keluarga | WNI | - | - | Muhammad Yusuf Sudarman | Endang Ayu Purnama |
| 2 | Kawin | Istri | WNI | - | - | Suparjo | Eka Sri Dermawan |
| 3 | Belum Kawin | Anak | WNI | - | - | Naufal Akbar Nugroho | Salsabila Adisty Cantika |
| 4 | Belum Kawin | Anak | WNI | - | - | Naufal Akbar Nugroho | Salsabila Adisty Cantika |
| 5 | - | - | - | - | - | - | - |
| 6 | - | - | - | - | - | - | - |
| 7 | - | - | - | - | - | - | - |
| 8 | - | - | - | - | - | - | - |
| 9 | - | - | - | - | - | - | - |
| 10 | - | - | - | - | - | - | - |