| No. | Nama | Paraf |
|---|---|---|
| 1 | SRI YANTI | |
| 2 | ARIF SUPIYANTO | |
| 3 | EKO ABDULHARIS | |
| 4 | ARI SUSANTO | |
| 5 | ZAMRODIN | |
| 6 | MUSTA'IN | |
| 7 | MUNIAH | |
| 8 | SAEFUDIN | |
| 9 | JUWARIYAH | |
| 10 | SETIYONO | |
| 11 | SAMBUDI | |
| 12 | AMIN ROHMADI | |
| 13 | SHOLEHAN | |
| 14 | IRFA'I | |
| 15 | DARMIYATI | |
| 16 | NGATINAH | |
| 17 | ROMDLONI | |
| 18 | SAEAN | |
| 19 | MUCHOZIN AL DAHRI | |
| 20 | JUMINI | |
| 21 | NURRODLIN | |
| 22 | ZAENAL MAHFUD | |
| 23 | SAYIDATUL MAHMUDAH | |
| 24 | MUHASYIM |