PEMERINTAH KABUPATEN LOMBOK TIMUR

RSUD Dr. R. SOEDJONO SELONG

Jalan Prof. M. Yamin, SH. No. 55 Selong 83612
Telepon ( 0376 ) 21118 – 21599 – 21415 Faks. (0376) 21415
Website : www.rsud.lomboktimurkab.go.id

East Lombok, February 8th 2019

No.

To :
Visa Application Centre
The Embassy of The Netherlands

Dear Sir/Madam

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

Name : Dr. H. M. Hasbi Santoso, M.Kes
Position : Director of East Lombok Regional Public Hospital

Certify that :
Name : Dr. Dadan Rohdiana, Sp.THT-KL
Position : Medical staff of ENT Department
Working since : March 1st 2016

Is planning to have vacation to The Netherlands on March 23 th 2019 until April 2nd 2019.

I acknowledge and guarantee that he will not seek any employment or permanent stay in your country
and will return to Indonesia soon after his holiday trip is completed. All kinds of expenses during the trip
are fully covered by his personal account.

Kindly grant his the necessary entry visa. Your kind assistance is highly appreciated.

Thank you for you good cooperation

Sincerely yours,

Dr. H. M. Hasbi Santoso, M. Kes

NIP. 196604291997031001