PEMERINTAH KABUPATEN CIREBON

DINAS KESEHATAN

UPT PUSKESMAS KLANGENAN

Jl.Ottista No.07 Telp. (0231) 341363 Klangenan Cirebon 45156

Cirebon, 23 September 2011

TO :Visa Section
Embassy of Netherland
Jakarta
Re : Recommendation Letter
Dear Sir / Madam,
The undersigned :
Name

: dr. H. Asep Firmansjah

RN
Position

: 197009042001121002
: Head of Public Health Service of Klangenan District

Herewith certify that my employee :

Name

: dr. Arnetta Naomi Louise Lalisang

RN
Position

: 1205100717
: Internship Doctor

Will be going to Amsterdam, Netherland for holiday for about days from .To .
I will guarantee that she will not seek any employment or permanent stay in your country and
will return to Indonesia after the end of the trip.
It will be highly appreciate if you could grant the necessary visa to enter your country legally.
Thank you very much for your kind attention and good coorperation.

Yours sincerely,

dr. H. Asep Firmansjah

Head of Public Health Service of Klangenan District