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To Comittee of INAMSC 2018,

Hereby, We, the undersigned,


First author : Devin Mahendika
Second author : Multzam Fahreza Chandra
Third author : Jian Hambali
Fourth author : -
Fifth author :-

Institution :
state that Research Paper / Literature Review/Public Poster, entitled:
“ …(insert your title)…”

is an original work of the authors above. This paper/poster has not been published or presented in
any competition, congress, or any other events and platforms out of Indonesia International
(Bio)Medical Students’ Congress (INAMSC) 2018.

Authors understand and agree to be fully responsible for the content of this paper/poster*. Should
there be any violation related to this work, authors are ready to be disqualified from INAMSC 2018.

Padang. , January 30th 2018

(Devin Mahedika)
*choose one
Note: This form could be electronically signed and could be saved as PDF format

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