Emmy Kholizah MC

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SURAT KETERANGAN ISTIRAHAT

MEDICAL CERTIFICATE
No. 002062/PBL/KFD-SMT5/MC/VIII/2023

Yang bertanda tangan dibawah ini, dokter klinik kimia farma menerangkan bahwa :
Undersigned, Klinik kimia farma doctor, declare that:

Nama : EMMY KHOLIZAH


Name
Tanggal Lahir : 25 Maret 1996/ March 25th 1996
Date Of Birth
Perusahaan : PEGAUNIHAN (ISPA)
Company
No. Pegawai : MW2300676
Badge
Alamat : RUSUN MUKA KUNING D/01
Address
No Telep/HP : 089674225524
Phone Number
Berdasarkan pemeriksaan medis yang dilakukan, bersangkutan menderita sakit, membutuhkan
istirahat sakit selama :
based on the medical examination carried out, the person concerned suffers from illness, requires sick
rest for:

Durasi Tanggal Mulai Tanggal Selesai Klinik


Duration Start From Until Date Healthcare Facility

2 Hari 21 Agustus 2023 22 Agustus 2023 KLINIK KIMIA FARMA 230 PANBIL
2 Days August 21st 2023 August 22nd 2023

Demikianlah agar yang berkepentingan maklum dan kepada yang bersangkutan agar
mempergunakan sebagaimana mestinya.
Therefore, this letter is issued to be used properly.

BATAM, 21 Agustus 2023


BATAM, August 21st 2023

dr. SAUL MELVIN RAJAGUKGUK


SIP: 068.I/001-355/SIP.TM/DPMPTSP-BTM/IV/2022 Scan Keaslian Dokumen
Scan to access original document

KLINIK KIMIA FARMA 230 PANBIL


Ruko
A: Panbil Blok A No.5, Kabil, Kota Batam, Kepulauan Riau 29437 | P: 082174621900 E: [email protected]

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