{"id":6065,"date":"2025-11-26T10:35:42","date_gmt":"2025-11-26T03:35:42","guid":{"rendered":"http:\/\/172.16.7.22\/ppid\/?page_id=6065"},"modified":"2026-10-03T12:51:37","modified_gmt":"2026-10-03T05:51:37","slug":"formulir-permohonan-informasi","status":"publish","type":"page","link":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/formulir-permohonan-informasi\/","title":{"rendered":"Formulir Permohonan Informasi"},"content":{"rendered":"<section class=\"ppid-nf\"><header><span>Pelayanan PPID &bull; RSUD Tebet<\/span><h1>Formulir Permohonan Informasi Publik<\/h1><p>Lengkapi data dan rincian informasi yang Anda perlukan.<\/p><\/header>\n        <form class=\"ppid-nf-form\" data-endpoint=\"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-admin\/admin-ajax.php\" data-kind=\"pmh\" enctype=\"multipart\/form-data\">\n      <div class=\"ppid-nf-message\" role=\"status\" aria-live=\"polite\" tabindex=\"-1\" hidden><\/div><div class=\"ppid-nf-fields\">\n                <div class=\"ppid-nf-field\" data-field=\"kategori_permohonan\">\n                    <label for=\"ppid-nf-1kategori_permohonan\">Kategori Permohonan<span aria-hidden=\"true\"> *<\/span><\/label>\n          <select id=\"ppid-nf-1kategori_permohonan\" name=\"kategori_permohonan\" required><option value=\"Perorangan\">Perorangan<\/option><option value=\"Kelompok\">Kelompok<\/option><option value=\"Badan Hukum\">Badan Hukum<\/option><\/select>\n                    <small class=\"ppid-nf-error\" id=\"ppid-nf-1kategori_permohonan-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"nik\">\n                    <label for=\"ppid-nf-1nik\">NIK<span aria-hidden=\"true\"> *<\/span><\/label>\n          <input id=\"ppid-nf-1nik\" type=\"text\" name=\"nik\" required inputmode=\"numeric\" pattern=\"[0-9]{16}\" maxlength=\"16\" title=\"NIK harus terdiri dari 16 angka\">          <small class=\"ppid-nf-error\" id=\"ppid-nf-1nik-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"nama\">\n                    <label for=\"ppid-nf-1nama\">Nama Lengkap<span aria-hidden=\"true\"> *<\/span><\/label>\n          <input id=\"ppid-nf-1nama\" type=\"text\" name=\"nama\" required maxlength=\"12000\">          <small class=\"ppid-nf-error\" id=\"ppid-nf-1nama-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"upload_ktp\">\n                    <label for=\"ppid-nf-1upload_ktp\">Upload KTP (JPG, JPEG, PNG atau PDF \u2014 maksimal 3 MB)<span aria-hidden=\"true\"> *<\/span><\/label>\n          <input id=\"ppid-nf-1upload_ktp\" type=\"file\" name=\"upload_ktp\" required accept=\".jpg,.jpeg,.png,.pdf\">          <small class=\"ppid-nf-error\" id=\"ppid-nf-1upload_ktp-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"alamat\">\n                    <label for=\"ppid-nf-1alamat\">Alamat<span aria-hidden=\"true\"> *<\/span><\/label>\n          <textarea id=\"ppid-nf-1alamat\" name=\"alamat\" rows=\"3\" maxlength=\"12000\" required><\/textarea>\n                    <small class=\"ppid-nf-error\" id=\"ppid-nf-1alamat-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"email\">\n                    <label for=\"ppid-nf-1email\">Email<span aria-hidden=\"true\"> *<\/span><\/label>\n          <input id=\"ppid-nf-1email\" type=\"email\" name=\"email\" required maxlength=\"12000\">          <small class=\"ppid-nf-error\" id=\"ppid-nf-1email-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"nomor_telepon\">\n                    <label for=\"ppid-nf-1nomor_telepon\">Nomor Telepon<span aria-hidden=\"true\"> *<\/span><\/label>\n          <input id=\"ppid-nf-1nomor_telepon\" type=\"text\" name=\"nomor_telepon\" required maxlength=\"12000\">          <small class=\"ppid-nf-error\" id=\"ppid-nf-1nomor_telepon-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"rincian_informasi\">\n                    <label for=\"ppid-nf-1rincian_informasi\">Rincian Informasi<span aria-hidden=\"true\"> *<\/span><\/label>\n          <textarea id=\"ppid-nf-1rincian_informasi\" name=\"rincian_informasi\" rows=\"3\" maxlength=\"12000\" required><\/textarea>\n                    <small class=\"ppid-nf-error\" id=\"ppid-nf-1rincian_informasi-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"tujuan_penggunaan_informasi\">\n                    <label for=\"ppid-nf-1tujuan_penggunaan_informasi\">Tujuan Penggunaan Informasi<span aria-hidden=\"true\"> *<\/span><\/label>\n          <textarea id=\"ppid-nf-1tujuan_penggunaan_informasi\" name=\"tujuan_penggunaan_informasi\" rows=\"3\" maxlength=\"12000\" required><\/textarea>\n                    <small class=\"ppid-nf-error\" id=\"ppid-nf-1tujuan_penggunaan_informasi-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"cara_memperoleh_informasi\">\n                    <label for=\"ppid-nf-1cara_memperoleh_informasi\">Cara Memperoleh Informasi<span aria-hidden=\"true\"> *<\/span><\/label>\n          <select id=\"ppid-nf-1cara_memperoleh_informasi\" name=\"cara_memperoleh_informasi\" required><option value=\"Melihat \/ Membaca\">Melihat \/ Membaca<\/option><option value=\"Mendengarkan\">Mendengarkan<\/option><option value=\"Mencatat\">Mencatat<\/option><option value=\"Mendapatkan salinan\">Mendapatkan salinan<\/option><\/select>\n                    <small class=\"ppid-nf-error\" id=\"ppid-nf-1cara_memperoleh_informasi-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"mendapatkan_salinan\">\n                    <label for=\"ppid-nf-1mendapatkan_salinan\">Mendapatkan Salinan Informasi<span aria-hidden=\"true\"> *<\/span><\/label>\n          <select id=\"ppid-nf-1mendapatkan_salinan\" name=\"mendapatkan_salinan\" required><option value=\"Softcopy\">Softcopy<\/option><option value=\"Hardcopy\">Hardcopy<\/option><\/select>\n                    <small class=\"ppid-nf-error\" id=\"ppid-nf-1mendapatkan_salinan-error\"><\/small><\/div>\n                <div class=\"ppid-nf-field\" data-field=\"cara_mendapatkan_salinan\">\n                    <label for=\"ppid-nf-1cara_mendapatkan_salinan\">Cara Mendapatkan Salinan Informasi<span aria-hidden=\"true\"> *<\/span><\/label>\n          <select id=\"ppid-nf-1cara_mendapatkan_salinan\" name=\"cara_mendapatkan_salinan\" required><option value=\"Diambil langsung\">Diambil langsung<\/option><option value=\"Email\">Email<\/option><option value=\"POS\/Jasa Pengiriman\">POS\/Jasa Pengiriman<\/option><\/select>\n                    <small class=\"ppid-nf-error\" id=\"ppid-nf-1cara_mendapatkan_salinan-error\"><\/small><\/div>\n      <\/div>\n      <div class=\"ppid-nf-trap\" aria-hidden=\"true\"><label>Website<input name=\"website\" tabindex=\"-1\" autocomplete=\"off\"><\/label><\/div>\n      <p class=\"ppid-nf-hint\">Kolom bertanda * wajib diisi. KTP: JPG, JPEG, PNG atau PDF, maksimal 3 MB.<\/p>\n      <button type=\"submit\">Kirim Permohonan<\/button>\n    <\/form><\/section>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":352,"parent":0,"menu_order":97,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-6065","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/pages\/6065","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/comments?post=6065"}],"version-history":[{"count":266,"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/pages\/6065\/revisions"}],"predecessor-version":[{"id":9975,"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/pages\/6065\/revisions\/9975"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/media\/352"}],"wp:attachment":[{"href":"https:\/\/rsudtebet.jakarta.go.id\/ppid\/wp-json\/wp\/v2\/media?parent=6065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}