| Nama | FARKHAM HIDAYATUL MUBAROK |  |
| NIS | 4795 | |
| Kelamin | Laki-laki | |
| Tmp/Tgl Lahir | Cilacap,05.11.2006 | |
| Agama | Islam | |
| Kelas | XII IPS 2 | |
| STTB | ||
| NEM | ||
| Orang tua | Kosim Rusyanto, S.Pd. | |
| Alamat Rumah | GANG MANYAR NO.12, Rt. 1, Rw. 6, Kel. TAMBAKREJA, Kec. KEDUN Telp.0838 6965 3328 |