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Satgas PPKPT Universitas Harapan Bangsa
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LAPOR
Contact Form Demo (#3)
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Form Laporan Kekesaran Seksual Dilingkungan Universitas Harapan Bangsa Purwokerto
Nama Lengkap
Jenis Identitas
Kartu Tanda Penduduk (KTP)
Kartu Tanda Mahasiswa (KTM)
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Alamat
Alamat
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No Hp
Email
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Mahasiswa
Dosen
Tenaga Kependidikan
Masyarakat Umum
Kategori Pelapor
- Select -
Korban
Pelapor/Saksi
Nama Terlapor
Status Pelapor
- Select -
Mahasiswa
Dosen
Tenaga Kependidikan
Masyarakat Umum
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