{"id":33,"date":"2025-09-18T13:28:24","date_gmt":"2025-09-18T05:28:24","guid":{"rendered":"https:\/\/dp3a-simangalean.my.id\/?page_id=33"},"modified":"2025-09-18T22:35:20","modified_gmt":"2025-09-18T14:35:20","slug":"formulir-laporan-pengaduan","status":"publish","type":"page","link":"https:\/\/dp3a-simangalean.my.id\/index.php\/formulir-laporan-pengaduan\/","title":{"rendered":"Form Laporan Pengaduan"},"content":{"rendered":"\n<p><br>\n<br>\n<br>\n    <meta charset=\"UTF-8\"><br>\n    <meta name=\"viewport\" content=\"width=device-width, initial-scale=1.0\"><br>\n    <title>FORMULIR LAPORAN PENGADUAN<\/title><\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\">\n<style>\n        body {<br \/>\n            font-family: Arial, sans-serif;<br \/>\n            background-color: #f4f4f4;<br \/>\n            padding: 20px;<br \/>\n        }<br \/>\n        .form-container {<br \/>\n            max-width: 800px;<br \/>\n            margin: auto;<br \/>\n            background: #fff;<br \/>\n            padding: 30px;<br \/>\n            border-radius: 8px;<br \/>\n            box-shadow: 0 0 15px rgba(0, 0, 0, 0.1);<br \/>\n        }<br \/>\n        h1, h2 {<br \/>\n            color: #333;<br \/>\n            border-bottom: 2px solid #ddd;<br \/>\n            padding-bottom: 10px;<br \/>\n            margin-top: 20px;<br \/>\n        }<br \/>\n        .form-section {<br \/>\n            margin-bottom: 30px;<br \/>\n        }<br \/>\n        .form-group {<br \/>\n            margin-bottom: 15px;<br \/>\n        }<br \/>\n        label {<br \/>\n            display: block;<br \/>\n            margin-bottom: 5px;<br \/>\n            font-weight: bold;<br \/>\n        }<br \/>\n        input[type=\"text\"], input[type=\"tel\"], select, textarea {<br \/>\n            width: 100%;<br \/>\n            padding: 10px;<br \/>\n            border: 1px solid #ccc;<br \/>\n            border-radius: 4px;<br \/>\n            box-sizing: border-box;<br \/>\n        }<br \/>\n        .radio-group label {<br \/>\n            font-weight: normal;<br \/>\n        }<br \/>\n        button {<br \/>\n            background-color: #007bff;<br \/>\n            color: white;<br \/>\n            padding: 12px 20px;<br \/>\n            border: none;<br \/>\n            border-radius: 5px;<br \/>\n            cursor: pointer;<br \/>\n            font-size: 16px;<br \/>\n            width: 100%;<br \/>\n            margin-top: 20px;<br \/>\n        }<br \/>\n        button:hover {<br \/>\n            background-color: #0056b3;<br \/>\n        }<br \/>\n    <\/style>\n<\/div>\n\n\n\n<p><br>\n<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"form-container\">\n<form id=\"complaintForm\" action=\"https:\/\/script.google.com\/macros\/s\/AKfycbx6kba_lD_HUc23b0LaPWOLYhG7tPpvI_OkjSMrT7yQ8JeYI03vyCuGGKiSaMLcVUvS\/exec\" method=\"POST\">\n<div class=\"form-section\">\n<h2>A. IDENTITAS PENGADU<\/h2>\n<div class=\"form-group\">\n                <label for=\"nama_pengadu\">Nama Lengkap<\/label><br>\n                <input type=\"text\" id=\"nama_pengadu\" name=\"nama_pengadu\" required=\"\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"nik_pengadu\">NIK<\/label><br>\n                <input type=\"text\" id=\"nik_pengadu\" name=\"nik_pengadu\" required=\"\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"ttl_pengadu\">TTL\/Umur<\/label><br>\n                <input type=\"text\" id=\"ttl_pengadu\" name=\"ttl_pengadu\" required=\"\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"alamat_pengadu\">Alamat<\/label><br>\n                <textarea id=\"alamat_pengadu\" name=\"alamat_pengadu\" rows=\"3\" required=\"\"><\/textarea>\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"nomor_hp_pengadu\">Nomor Tlp\/HP<\/label><br>\n                <input type=\"tel\" id=\"nomor_hp_pengadu\" name=\"nomor_hp_pengadu\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"hubungan_pengadu\">Hubungan dengan klien<\/label><br>\n                <select id=\"hubungan_pengadu\" name=\"hubungan_pengadu\"><option value=\"Anak\">Anak<\/option><option value=\"Saudara Kandung\">Saudara Kandung<\/option><option value=\"Tetangga\">Tetangga<\/option><option value=\"Lainnya\">Lainnya<\/option><\/select>\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"kasus\">Kasus<\/label><br>\n                <input type=\"text\" id=\"kasus\" name=\"kasus\">\n            <\/div>\n<div class=\"form-group\">\n                <label>Penerimaan melapor ke DPPPA Minahasa\/UPTD PPA dengan cara melalui<\/label><p><\/p>\n<div class=\"radio-group\">\n                    <input type=\"radio\" id=\"datang_langsung\" name=\"cara_melapor\" value=\"Datang langsung\" required=\"\"><br>\n                    <label for=\"datang_langsung\">Datang langsung<\/label><br>\n                    <input type=\"radio\" id=\"pihak_lain\" name=\"cara_melapor\" value=\"Pihak lain\"><br>\n                    <label for=\"pihak_lain\">Pihak lain<\/label><br>\n                    <input type=\"radio\" id=\"rujukan\" name=\"cara_melapor\" value=\"Rujukan\"><br>\n                    <label for=\"rujukan\">Rujukan<\/label><br>\n                    <input type=\"radio\" id=\"pelimpahan\" name=\"cara_melapor\" value=\"Pelimpahan\"><br>\n                    <label for=\"pelimpahan\">Pelimpahan<\/label><br>\n                    <input type=\"radio\" id=\"tetangga\" name=\"cara_melapor\" value=\"Tetangga\"><br>\n                    <label for=\"tetangga\">Tetangga<\/label><br>\n                    <input type=\"radio\" id=\"lainnya_melapor\" name=\"cara_melapor\" value=\"Lainnya\"><br>\n                    <label for=\"lainnya_melapor\">Lainnya<\/label>\n                <\/div>\n<p><\/p><\/div>\n<p><\/p><\/div>\n<div class=\"form-section\">\n<h2>B. IDENTITAS KLIEN\/KORBAN<\/h2>\n<div class=\"form-group\">\n                <label for=\"nama_klien\">Nama Lengkap<\/label><br>\n                <input type=\"text\" id=\"nama_klien\" name=\"nama_klien\" required=\"\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"nik_klien\">NIK<\/label><br>\n                <input type=\"text\" id=\"nik_klien\" name=\"nik_klien\" required=\"\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"ttl_klien\">TTL\/Umur<\/label><br>\n                <input type=\"text\" id=\"ttl_klien\" name=\"ttl_klien\" required=\"\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"alamat_klien\">Alamat<\/label><br>\n                <textarea id=\"alamat_klien\" name=\"alamat_klien\" rows=\"3\" required=\"\"><\/textarea>\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"nomor_hp_klien\">Nomor Tlp\/HP<\/label><br>\n                <input type=\"tel\" id=\"nomor_hp_klien\" name=\"nomor_hp_klien\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"agama_klien\">Agama<\/label><br>\n                <input type=\"text\" id=\"agama_klien\" name=\"agama_klien\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"pendidikan_klien\">Status Pendidikan<\/label><br>\n                <input type=\"text\" id=\"pendidikan_klien\" name=\"pendidikan_klien\">\n            <\/div>\n<p><\/p><\/div>\n<div class=\"form-section\">\n<h2>C. IDENTITAS TERLAPOR<\/h2>\n<div class=\"form-group\">\n                <label for=\"nama_terlapor\">Nama Lengkap<\/label><br>\n                <input type=\"text\" id=\"nama_terlapor\" name=\"nama_terlapor\" required=\"\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"nil_terlapor\">NIL<\/label><br>\n                <input type=\"text\" id=\"nil_terlapor\" name=\"nil_terlapor\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"ttl_terlapor\">TTL\/Umur<\/label><br>\n                <input type=\"text\" id=\"ttl_terlapor\" name=\"ttl_terlapor\" required=\"\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"alamat_terlapor\">Alamat<\/label><br>\n                <textarea id=\"alamat_terlapor\" name=\"alamat_terlapor\" rows=\"3\" required=\"\"><\/textarea>\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"nomor_hp_terlapor\">Nomor Tlp\/HP<\/label><br>\n                <input type=\"tel\" id=\"nomor_hp_terlapor\" name=\"nomor_hp_terlapor\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"agama_terlapor\">Agama<\/label><br>\n                <input type=\"text\" id=\"agama_terlapor\" name=\"agama_terlapor\">\n            <\/div>\n<div class=\"form-group\">\n                <label for=\"hubungan_terlapor\">Hubungan dengan Korban<\/label><br>\n                <select id=\"hubungan_terlapor\" name=\"hubungan_terlapor\"><option value=\"Suami\">Suami<\/option><option value=\"Anak Kandung\">Anak Kandung<\/option><option value=\"Anak Tiri\">Anak Tiri<\/option><option value=\"Tetangga\">Tetangga<\/option><option value=\"Lainnya\">Lainnya<\/option><\/select>\n            <\/div>\n<div class=\"form-group\">\n                <label>Petugas Penerima Layanan<\/label><p><\/p>\n<div class=\"radio-group\">\n                    <input type=\"radio\" id=\"petugas_pelapor\" name=\"petugas_penerima\" value=\"Pelapor\" required=\"\"><br>\n                    <label for=\"petugas_pelapor\">Pelapor<\/label><br>\n                    <input type=\"radio\" id=\"petugas_korban\" name=\"petugas_penerima\" value=\"Korban\"><br>\n                    <label for=\"petugas_korban\">Korban<\/label>\n                <\/div>\n<p><\/p><\/div>\n<p><\/p><\/div>\n<p>        <button type=\"submit\">Kirim Laporan<\/button><br>\n    <\/p><\/form>\n<\/div>\n<\/div>\n\n\n\n<p><br>\n<\/p>\n","protected":false},"excerpt":{"rendered":"<p>FORMULIR LAPORAN PENGADUAN A. IDENTITAS PENGADU Nama Lengkap NIK TTL\/Umur Alamat Nomor Tlp\/HP Hubungan dengan klien AnakSaudara KandungTetanggaLainnya Kasus Penerimaan melapor ke DPPPA Minahasa\/UPTD PPA dengan cara melalui Datang langsung Pihak lain Rujukan Pelimpahan Tetangga Lainnya B. IDENTITAS KLIEN\/KORBAN Nama Lengkap NIK TTL\/Umur Alamat Nomor Tlp\/HP Agama Status Pendidikan C. IDENTITAS TERLAPOR Nama Lengkap NIL [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":44,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-33","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/pages\/33","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/comments?post=33"}],"version-history":[{"count":9,"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/pages\/33\/revisions"}],"predecessor-version":[{"id":90,"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/pages\/33\/revisions\/90"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/media\/44"}],"wp:attachment":[{"href":"https:\/\/dp3a-simangalean.my.id\/index.php\/wp-json\/wp\/v2\/media?parent=33"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}