(Add more rows as needed) (Right Aligned) __________, _________________ Kepala Keluarga / Pemilik Data
No. KK : ____________________ (Use Word Table – no vertical borders, horizontal lines only if needed) | Data Umum | Keterangan | |---------------|----------------| | Nama Kepala Keluarga | ____________________ | | Alamat | ____________________ | | | RT/RW : ________ / ________ | | | Kel/Desa : ____________________ | | | Kecamatan : ____________________ | | | Kab/Kota : ____________________ | | | Provinsi : ____________________ | | | Kode Pos : ____________________ | Anggota Keluarga (Table format) | No | Nama Lengkap | NIK | Hubungan Keluarga | Jenis Kelamin (L/P) | Tempat Lahir | Tanggal Lahir | Agama | Pendidikan | Pekerjaan | |----|--------------|-----|-------------------|----------------------|---------------|----------------|--------|------------|------------| | 1. | ________ | ________ | Kepala Keluarga | ________ | ________ | ________ | ________ | ________ | ________ | | 2. | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | | 3. | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | | 4. | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | | 5. | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | | 6. | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | | 7. | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | | 8. | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | ________ | format kartu keluarga kosong word