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files >> C:/siak/TOOL SIAK/siak73/app/Siak/application/views/cetak/capil/aktaKematian.php
<html> <head> <link href="../../java/cetak/css/style.css" rel="stylesheet" type="text/css" /> <style type="text/css" media="print,screen"> @page{ size:A4;} .baris_register tr{ line-height:16px;} table{ margin-left:44px; } </style> </head> <body> <table width="175mm" class="atas kiri baris_register font12"> <tr> <td width="25mm">Pada hari ini</td> <td width="38mm">isi</td> <td width="20mm">tanggal</td> <td width="80mm">isi</td> <td width="12mm">tahun</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="71mm">isi</td> <td width="45mm">hadir dihadapan saya</td> <td width="59mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="16mm">Kepala</td> <td width="159mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="6mm">di</td> <td width="115mm">isi</td> <td width="54mm">seorang pelapor bernama</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="72mm">isi</td> <td width="15mm">umur</td> <td width="16mm">isi</td> <td width="37mm">tahun, pekerjaan</td> <td width="35mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="68mm">isi</td> <td width="43mm">alamat tempat tinggal</td> <td width="64mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="8mm">RT</td> <td width="10mm">isi</td> <td width="13mm">RW</td> <td width="9mm">isi</td> <td width="34mm">Kelurahan/Desa</td> <td width="77mm">isi</td> <td width="24mm">Kecamatan</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="56mm">isi</td> <td width="35mm">Kabupaten/Kota</td> <td width="65mm">isi</td> <td width="19mm">Provinsi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="59mm">isi</td> <td width="116mm">dengan membawa persyaratan :</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">1</td> <td width="73mm">isi</td> <td width="12mm">3</td> <td width="83mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">2</td> <td width="73mm">isi</td> <td width="12mm">3</td> <td width="83mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="38mm">melaporkan bahwa di</td> <td width="38mm">isi</td> <td width="23mm">pada hari</td> <td width="30mm">isi</td> <td width="19mm">tanggal</td> <td width="27mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="13mm">tahun</td> <td width="42mm">isi</td> <td width="17mm">pukul</td> <td width="45mm">isi</td> <td width="58mm">telah meninggal dunia seorang</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="19mm">bernama</td> <td width="61mm">isi</td> <td width="19mm">lahir di</td> <td width="50mm">isi</td> <td width="26mm">pada tanggal</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="47mm">isi</td> <td width="17mm">tahun</td> <td width="90mm">isi</td> <td width="174mm">pekerjaan</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="55mm">isi</td> <td width="56mm">alamat terakhir</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="53mm">isi</td> <td width="12mm">RT</td> <td width="11mm">isi</td> <td width="19mm">RW</td> <td width="12mm">isi</td> <td width="34mm">Kelurahan/Desa</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="23mm">Kecamatan</td> <td width="75mm">isi</td> <td width="34mm">Kabupaten/Kota</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="17mm">Provinsi</td> <td width="86mm">isi</td> <td width="20mm">anak ke</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="36mm">laki-laki/perempuan</td> <td width="92mm">isi</td> <td width="16mm">umur</td> <td width="18mm">isi</td> <td width="174mm">tahun</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="21mm"21>pekerjaan</td> <td width="67mm"67>isi</td> <td width="44mm">alamat tempat tinggal</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="53mm">isi</td> <td width="18mm">RT</td> <td width="13mm">isi</td> <td width="13mm">RW</td> <td width="10mm">isi</td> <td width="34mm">Kelurahan/Desa</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="23mm">Kecamatan</td> <td width="43mm">isi</td> <td width="35mm">Kabupaten/Kota</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="17mm">Provinsi</td> <td width="46mm">isi</td> <td width="12mm">dan</td> <td width="53mm">isi</td> <td width="15mm">umur</td> <td width="21mm">isi</td> <td width="174mm">tahun</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="21mm">pekerjaan</td> <td width="70mm">isi</td> <td width="44mm">alamat tempat tinggal</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="9mm">RT</td> <td width="8mm">isi</td> <td width="12mm">RW</td> <td width="8mm">isi</td> <td width="34mm">Kelurahan/Desa</td> <td width="36mm">isi</td> <td width="25mm">Kecamatan</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="31mm">Kabupaten/Kota</td> <td width="43mm">isi</td> <td width="20mm">Provinsi</td> <td width="34mm">isi</td> <td width="174mm">Pencatatan Kematian ini</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">1</td> <td width="70mm">isi</td> <td width="15mm">umur</td> <td width="8mm">isi</td> <td width="36mm">tahun, pekerjaan</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">jeda</td> <td width="41mm">alamat tempat tinggal</td> <td width="95mm">isi</td> <td width="14mm">RT</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">jeda</td> <td width="10mm">RW</td> <td width="9mm">isi</td> <td width="34mm">Kelurahan/Desa</td> <td width="48mm">isi</td> <td width="20mm">Kecamatan</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">jeda</td> <td width="30mm">Kabupaten/Kota</td> <td width="63mm">isi</td> <td width="20mm">Provinsi</td> <td width="174mm">isi</td> </tr> </table><table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">2</td> <td width="70mm">isi</td> <td width="15mm">umur</td> <td width="8mm">isi</td> <td width="36mm">tahun, pekerjaan</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">jeda</td> <td width="41mm">alamat tempat tinggal</td> <td width="95mm">isi</td> <td width="14mm">RT</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">jeda</td> <td width="10mm">RW</td> <td width="9mm">isi</td> <td width="34mm">Kelurahan/Desa</td> <td width="48mm">isi</td> <td width="20mm">Kecamatan</td> <td width="174mm">isi</td> </tr> </table> <table width="174mm" class="atas kiri baris_register font12"> <tr> <td width="7mm">jeda</td> <td width="30mm">Kabupaten/Kota</td> <td width="63mm">isi</td> <td width="20mm">Provinsi</td> <td width="174mm">isi</td> </tr> </table> <table width="100%"> <tr> <td>tanda tangan, <br />saksi pertama </td> <td>pelapor</td> <td>saksi kedua </td> </tr> </table> <table width="100%"> <tr> <td>isi</td> <td>kep</td> </tr> </table> </body> </html>
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