THE DISPENSATION LETTER

To whom it may concerned,

I am dr. ...., General Practicing Doctor on ... Medical Clinic, would like to describe that :
Name :
Sex :
Age :
Address :

Needs to ask permission for 7 days from 21rd of November 2013 until 27th of November
2013 because caring of the patient (his wife) that still getting treatment on our clinic.
I hope this description can be used appropriately.

Purworejo, 21rd of November 2013

Reqards

( dr. ...)
General Practicing Doctor