Brebes , September 13th ,2016

To :
The Embassy of Schengen Countries
Visa Section
Jakarta

Subject : Tourist Visa Application

To Whom It May Concern,

This is to certify that:
Name

: Subiyakto

Place & Date of Birth : Kudus ,November 20th 1982

Current Address

: Jl. Waru Timur Raya 12, Banyumanik, Semarang

Currently employed by Bhakti Asih Hospital Brebes, Central Java Province, Republic Of
Indonesia as a Surgeonworking Since 1 February 2016 Until Now . He will visit Schengen
Countriesfrom the period of 22thNovember 2016until 30thNovember 2016 for holiday.
Hewill come back to Indonesia on 30thNovember2016.
All the expenses such as air ticket and accommodation during in your country will be spend
from his personal account.
We will guarantee that he will return to Indonesia as soon as his trip is over, without
seeking for any kind of employment or permanent resident and promise he will obey every
regulation in your country. He will still be employed by Bhakti Asih Hospital Brebes ,
Central Java Province, Republic Of Indonesia and will come back to work in after his leave
is over.
It would be highly appreciated if you could grant his the tourist visa to enter your country.
Should you need additional information on his employment details, please do not hesitate to
contact the undersigned.
Yours sincerely,
Director of Bhakti Asih
Bhakti Asih Hospital Brebes, Central Java Province

dr. Khosiatun Azmi, MMR

(+628122774128 )

Brebes , September 13th ,2016

To :
The Embassy of Schengen Countries
Visa Section
Jakarta

Subject : Tourist Visa Application

To Whom It May Concern,

This is to certify that:
Name

: Dewi Widya Puspita

Place & Date of Birth : Pati, April 20th 1984

Current Address

: Jl. Waru Timur Raya 12, Banyumanik, Semarang

Currently employed by Bhakti Asih Hospital Brebes, Central Java Province, Republic Of
Indonesia as a Radiologist Since 1st February 2016 Until Now . He will visit Schengen
Countriesfrom the period of 22th November 2016 until 30th November 2016 for holiday.
She will come back to Indonesia on 30th November 2016.
All the expenses such as air ticket and accommodation during in your country will be spend
from her personal account.
We will guarantee that she will return to Indonesia as soon as her trip is over, without
seeking for any kind of employment or permanent resident and promise she will obey every
regulation in your country. He will still be employed by Bhakti Asih Hospital Brebes ,
Central Java Province, Republic Of Indonesia and will come back to work in after his leave
is over.
It would be highly appreciated if you could grant his the tourist visa to enter your country.
Should you need additional information on his employment details, please do not hesitate to
contact the undersigned.
Yours sincerely,
Director of Bhakti Asih
Bhakti Asih Hospital Brebes, Central Java Province

dr. Khosiatun Azmi, MMR

(+628122774128 )