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Permohonan Data

Nama Lengkap (Full Name)

No. KTP (National ID Number (KTP))

Email (Email)

Pekerjaan (Employment/Student Status)

Alamat Sesuai KTP (Address (as in ID))

Nomor HP (Telephone Number)

Nama Instansi/Perguruan Tinggi/Sekolah (Institution Name)

Tujuan Permohonan Data (Purpose of Data Request)

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Data yang Dibutuhkan :

Instansi (Institution)

Tanggal Awal Data (Start Date)

Tanggal Akhir Data (End Date)

Jenis Data (Data Type)

Pos Pengamatan (Observation Station)

Permohonan Data SIH3