| IDENTITAS IDUKA | |
| Nama IDUKA | : PT.Sogeh Bareng Berguna |
| Alamat IDUKA | : Jl. Tambak Dalam Baru III No.34, Asem Rowo, Kec. Asem Rowo, Surabaya, Jawa Timur 60182 |
| Pelaksanaan | : 13 Oktober 2025 s/d 13 Februari 2026 |
| Nama Direktur/ Pimpinan *) | : ........................................................................ |
| Nama Pembimbing *) | : ........................................................................ |
| No HP/ WA Pembimbing | : ........................................................................ |
| IDENTITAS PESERTA | |
| Nama Siswa | : AHMAD KHOIRUL ABID / XII TKJ |
| HP Siswa | : 081332851618 |
| HP Orangtua | : 085755519584 |
| No | Tanggal Kunjungan | Uraian Kegiatan | Catatan | Paraf/stempel Pembimbing IDUKA | Petugas Monitoring |
| 1 | |||||
| 2 | |||||
| 3 |
| Hasil Pelaksanaan PKL :
.............................................................................................................................................................................................................................................. .............................................................................................................................................................................................................................................. .............................................................................................................................................................................................................................................. |
| Panitia PKL .................... NBM : |