KLINIK ALIYA BITUNG

Jl. Raya Serang KM. 10 Pos Bitung. Tangerang

Banten.15810.Telp. (021) 5980011

Tangerang, 24 September 2019

Nomor : 2/PR-KAB/IX/19 Kepada Yth :
Perihal : Perubahan Dokter Kepala Cabang BPJS Kesehatan
Pelaksana Harian di
Tiga Raksa

Dengan hormat,
Sehubungan berakhir nya SIP dokter Pelaksana harian di Klinik ALIYA BITUNG a/n dr
Angkoril Kahar Siregar (No:446.1/1336/6391-Dinkes/2018) pada 29/10/2019 dan Surat
Persetujuan Perubahan Dokter Pelaksana Harian dari DPMPTSP No. 445/990-DPMPTSP/2019.
Kami bermaksud memberitahukan perubahan tersebut kepada BPJS Kesehatan Tiga
Raksa, terkait Pengajuan Perubahan Tenaga Medis dalam HFIS yang telah kami ajukan pada
23/9/2019.
Demikian surat ini kami sampaikan, atas perhatian dan kerjasama nya kami ucapkan
terima kasih.

Pimpinan Klinik Aliya Bitung

drg. Lia .S. Daliani, MARS

To :

Visa Section of
EMBASSY OF AUSTRALIA
JAKARTA

Dear Sir/Madam,

With this letter, I would like to inform you that I am the undersigned,

Nama : NURHANUDIN, S.Kom.

Position : Administrator
Working Since : March 1,2019
Would like to certify that,

Name : ARVIN DWIARRAHMAN

Position : Commissioner
Working Since : February 2016
Are planning to have vacation to Australia, will be depart from Jakarta on September 2019.

I will not seek any employment or permanent stay into your country and will return to Indonesia soon
after my holiday trip is completed. All kinds of expenses during the trip of above purpose are fully
covered by my personal account.

Your kind assistance will be very highly appreciated.

Sincerely yours,

Nurhanudin, S.Kom.
Administrator