HEALTH RECOMMENDATION

Here by the Doctor on charge at Departement of Child Health, Amalia Hospital of Bontang East
Kalimantan recommend that the infant / child as follows :
Name
Birth date
Sex
Name of father / mother
Address
Phone

:
:
:
:
:
:

During the examination performed , the condition of the infant / child was perfect health and
there was no other contraindiation for attending TRAVELLING FLIGHT.
This HEALTH RECOMMENDATION is expressed to whom it may concern.
Bontang,
Sincerely,

NIP :