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Faculty of Medicine

Udayana University
Jalan P.B. Sudirman
Denpasar – Bali
Indonesia

8 March 2016

Urology Department
Mount Elizabeth Hospital
Singapore

Dear Dr. Steven Chow.

Re : Mr. Parma, Age : 64 year old.
I am referring to you this patient with the following history and findings, for further assessment and
management.
After taking the history, it is found that he is suffering from chronic kidney failure due to stones in
both kidneys. Relevant tests, including ultrasonography, blood and urine tests have been done here in
Sanglah Hospital, Denpasar, Bali.

Attached, please find the ultrasonograpy and laboratory results.

We are looking forward for your reply.
I thank you for your attention and assistance.

Yours sincerely,
dr.x

Amman Re : Mr. Yours sincerely. This man has history of acute colicky abdominal and flank pain. 12 Denpasar 80223 I am referring to you this patient with the following history and findings for general abdominal ultrasonography (USG). B. 12 Denpasar Dear Dr. Age : 55 year old. Sudirman Denpasar – Bali Indonesia 8 March 2016 Radiologist Jalan Sudirman no. I thank you for your attention and assistance.Faculty of Medicine Udayana University Jalan P. Jalan Buton no. dr. x . Daniel. including the kidneys.

x . 52 year old. To Whom It May Concern This is to certify that I have been today examnied Mr. 10 March 2016 The examining physician dr. Arman. Denpasar. Home address: Jalan Sumatra no. Denpasar and I have found him to be unfit on duty due to being ill (with fever. 34. Date to ressume duty: 14 March 2016. cough and shortness of breath) from 11 up to 13 March 2016.