Bismillahirrohmanirrahim DATA PELANGGAN 1. Nama : ............................................................ ......................................... 2. Alamat : ............................................................ ......................................... 3. Telp. : ............................................................ ......................................... 4. No. HP Layanan : .............................................. 5. Jenis Layanan (lingkari) : 1. Biasa 2. Plus Group Ikhwan 3. Plus Group Ummahat 6. Berlangganan mulai bulan : ........................................... Bontang, .................. .................. 2009 Pelanggan (___________________) KWITANSI PEMBAYARAN Telah terima dari : Nama : ............................................................ ............................................................. No. Pelanggan : ................... No. HP Layanan : ......................................................... .......... Nomer :
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BismillahirrohmanirrahimDATA PELANGGAN
1. Nama : .....................................................................................................
2. Alamat : .....................................................................................................
3. Telp. : .....................................................................................................
4. No. HP Layanan : ..............................................
5. Jenis Layanan (lingkari) : 1. Biasa 2. Plus Group Ikhwan 3. Plus Group Ummahat
6. Berlangganan mulai bulan : ...........................................
Bontang, .................................... 2009
Pelanggan
(___________________)
KWITANSI PEMBAYARAN
Telah terima dari :
Nama : .........................................................................................................................
No. Pelanggan : ................... No. HP Layanan : ...................................................................
Uang sebesar : Rp....................................................................................................................
Untuk pembayaran biaya berlangganan bulan :.....................................................................................
Terbilang :
Bontang, ...........................2009
Penyetor Petugas
( ) ( )
Lembar untuk An-Nashihah
KWITANSI PEMBAYARAN
Telah terima dari :
Nama : .......................................................................................................................
No. Pelanggan : ................... No. HP Layanan : ...................................................................
Uang sebesar : Rp....................................................................................................................
Untuk pembayaran biaya berlangganan bulan :.....................................................................................
Terbilang :
Bontang, ...........................2009
Penyetor Petugas
( ) ( )
Lembar untuk pelanggan
Nomer :
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