| No. | Nama | Paraf |
|---|---|---|
| 1 | TRIYATI | |
| 2 | SUYITNO | |
| 3 | SUKIRAH | |
| 4 | MUJILAH | |
| 5 | SOLIKAH | |
| 6 | YAMINI | |
| 7 | SARJIMAN | |
| 8 | JUWADI | |
| 9 | MUDIYONO | |
| 10 | SUWONO | |
| 11 | TIMBUL AL SUMARTO | |
| 12 | SUWADI | |
| 13 | TARJO | |
| 14 | SUJONO | |
| 15 | DARNYOTO | |
| 16 | SUNARTO | |
| 17 | NURYONO | |
| 18 | MUNARI | |
| 19 | SUYAMINAH | |
| 20 | SLAMET | |
| 21 | MARSIDI | |
| 22 | SUKIRMAN | |
| 23 | MUTAROM | |
| 24 | SARMIDI | |
| 25 | RUSMAN | |
| 26 | CUPLIK | |
| 27 | MARYANTO | |
| 28 | RUMANTI | |
| 29 | AMONG HANDJONO | |
| 30 | MUNTOFIAH | |
| 31 | SODIK KHOLIFIN | |
| 32 | SARJITO | |
| 33 | WIGNJA | |
| 34 | MUKADI | |
| 35 | TUKIYAT | |
| 36 | SUSILO | |
| 37 | AGUS RIYADI | |
| 38 | PURWADI | |
| 39 | MURYANTO | |
| 40 | DUWI TUSILOWATI | |
| 41 | SUMADI |