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SURAT PERNYATAAN

Saya yang bertanda tangan di bawah ini: Nama NIM Jurusan Fakultas : Lukita Pradhevi : 010911182 : Pendidikan Dokter : Kedokteran

Sampai dengan saat ini saya tidak sedang menerima beasiswa dari pihak manapun dan dalam bentuk apapun. Demikian surat pernyataan ini saya buat dengan sebenar-benarnya.

Surabaya, Yang menyatakan

Lukita Pradhevi 010911182

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