Our Ref : Medan, April 26, 2017

The Embassy of Japan

Attn. Visa Section
In-
M E DAN

Subject : Visa Application

We would like herewith to apply a visit visa for :

Name/NIP : Henro Edy Saputra Saraan / 198204022006041001

Position : Nurse in intensif Care instalations of Adam Malik General Hospital
They intends to visit Japan for approximately 20 (twenty) days, beginning on 08 27 May 2017 to
attend Advance Training for Curriculum Development of Disaster Nursing (J1721505).

All kind of expenses during the visit will be covered by JICA

Your assistance on this matter is highly appreciated.

o.b.o. Dean of Intensif Care Instalations of

Adam Malik General Hospital
Yours Sincerely,

Prof.dr.Achsanuddin Hanafie, SpAn,KIC,KAO

NIP : 195208261981021001