| No. | Nama | Paraf |
|---|---|---|
| 1 | SUPRIYADI | |
| 2 | SUMARNI | |
| 3 | MARIYAM | |
| 4 | WALMAN | |
| 5 | RUNTUNG | |
| 6 | MUH AZIS | |
| 7 | RATNO | |
| 8 | KABUL PAMBAJENG | |
| 9 | RUBET | |
| 10 | SUWOTO | |
| 11 | HAMSAR | |
| 12 | ISTIJAB | |
| 13 | DAHONO | |
| 14 | SURATMAN | |
| 15 | SUGENG | |
| 16 | SUYOTO | |
| 17 | RIYANTO | |
| 18 | MARMAN | |
| 19 | MUKARTO | |
| 20 | ANDARTI WINARSIH | |
| 21 | NGADIMIN | |
| 22 | RAMBAT ASTUTI | |
| 23 | RATNO | |
| 24 | NURYUBAT | |
| 25 | MUJIBAH | |
| 26 | AHMAD SLAMET | |
| 27 | PARWADI | |
| 28 | TRIYONO |