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
Faculty of Medicine
Udayana University
Jalan P. B. Sudirman
Denpasar Bali
Indonesia

8 March 2016

Radiologist
Jalan Sudirman no. 12
Denpasar

Dear Dr. Amman

Re : Mr. Daniel, Age : 55 year old.

Jalan Buton no. 12
Denpasar 80223

I am referring to you this patient with the following history and findings for general abdominal
ultrasonography (USG), including the kidneys.

This man has history of acute colicky abdominal and flank pain.

I thank you for your attention and assistance.

Yours sincerely,

dr. x
 To Whom It May Concern

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

Denpasar, 10 March 2016

The examining physician

dr. x