PROVINSI DAERAH KHUSUS IBUKOTA JAKARTA
DAFTAR NILAI
UJIAN
SEKOLAH/MADRASAH
BERSTANDAR
NASIONAL (US/M BN) SD/MI/SDLB
TAHUN PELAJARAN 2017/2018
Kabupaten/Kota : …………………………………………………………………….
Subrayon/Kecamatan : …………………………………………………………………….
Sekolah/Madrasah : …………………………………………………………………….
Hari, Tanggal : …………………………………………………………………….
Mata
Pelajaran : …………………………………………………………………….
Ruang Ujian : …………………………………………………………………….
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No. Urt.
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Nomor Peserta
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Nama Peserta
(Isi Dengan Huruf Cetak)
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Nilai
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Nilai
(P1)
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Nilai
(P2)
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Jumlah
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Rata rata
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Ketr
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Jawaban Essay
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1
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2
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3
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4
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5
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Jml
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25%
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1
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2
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3
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4
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5
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6
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7
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8
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9
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10
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11
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12
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13
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14
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15
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16
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17
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18
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19
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20
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PEMERIKSA 1
PEMERIKSA 2
.............................................
............................................
NIP
NIP.
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