Professional Documents
Culture Documents
Final Announcement.2
Final Announcement.2
FINAL
ANNOUNCEMENT
FIRST ANNOUNCEMENT
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TABLE OF CONTENT
GREETINGS FROM PRESIDENT OF IOSSMA ............................ 1
GREETINGS FROM CHAIRMAN ................................................... 2
COMMITTEE ..................................................................................... 3
GENERAL INFORMATION .............................................................. 4
FACULTY MEMBERS ........................................................................ 5
PROGRAM AT GLANCE ................................................................... 6
WORKSHOP ...................................................................................... 7
SYMPOSIUM ..................................................................................... 8
ABSTRACT SUBMISSION GUIDELINES ..................................... 12
REGISTRATION AND ACCOMMODATION INFORMATION ..... 14
REGISTRATION FORM ................................................................. 16
ACCOMMODATION FORM ............................................................. 17
HOTEL ROOM .............................................................................. 18
The 4th Congress And 10th Annual Meeting Of IOSSMA
INDONESIAN ORTHOPEDIC SOCIETY FOR SPORTS MEDICINE AND ARTHROSCOPY
We cordially invite you for the 4th congress and 10th annual-
meeting of IOSSMA with theme “Advancing Arthroscopic Sur-
gery in Orthopaedic Sports Injury” on September 1st – 3rd in
Pullman & Ibis Styles Bandung Grand Central, Bandung, Indo-
nesia.
This meeting will provide various innovations and cutting-edge surgical techniques as
well as approaches from national and international expert speakers. They will share
experiences, knowledge, new techniques, and advanced technique of arthroscopic
surgery in the management of sports injuries.
The event will be served in various educational programs such as lectures, symposia,
workshops, and poster presentations.
We sincerely welcome you for attending the IOSSMA meeting while exploring Bandung,
an astonishing destination with great weather, scenery, beverages, and culture. Until
we meet on September 2022 in Bandung. Best regard from us.
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This event will be held in the city of Bandung, one of the largest cities in Indonesia, the
center of education, and also a world-famous tourist destination. Bandung offers various
kinds of culture, entertainment, and various types of culinary which are very famous.
This meeting also will be carried out following the applicable health protocol rules.
We sincerely hope that you can mark our event on your agenda, and we are looking
forward to welcoming you to Bandung. See you all at the event.
Wahyu Riansyah, MD
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The 4th Congress And 10th Annual Meeting Of IOSSMA
INDONESIAN ORTHOPEDIC SOCIETY FOR SPORTS MEDICINE AND ARTHROSCOPY
COMMITTEE
PATRON FUNDRAISER
Prof. Errol U. Hutagalung, MD, PhD Coordinator
Prof. Putu Astawa, MD, PhD Isa An Nagib, MD
Prof. Idrus A. Paturusi, MD, PhD
Dohar A. L Tobing, MD Vice Coordinator
Prof. Hermawan Nagar R, MD, PhD Andi Nusawarta, MD
Prof. Ismail H. D, MD, PhD
Member
PRESIDENT IOSSMA 2019-2022 Henry Suhendra, MD
Muhammad Sakti, MD, PhD Lia Marliana, MD
IGM Febry Siswanto, MD
PRESIDENT ELECT IOSSMA 2022-2025 IGN Wien Aryana, MD
Ghuna A. Utoyo, MD Julia Kveta, MD
Evan, MD
CHAIRMAN
Wahyu Riansyah, MD WORKSHOP
Coordinator
VICE CHAIRMAN Jafri Hasan, MD
Troydimas Panjaitan, MD
Vice Coordinator
SECRETARY Alvin da Costa, MD
Astuti Pitarini, MD
Member
TREASURE Didi Hertanto, MD
Nadia Nastassia P.P.S Ifran, MD Ronny Sutanto, MD
Adisa Yusuf, MD
SCIENTIFIC
Coordinator
Andri M.T Lubis, MD, PhD
Vice Coordinator
Erick Wonggokusuma, MD
Member
Prof. Hermawan Nagar R, MD, PhD
Bobby N. Nelwan, MD
Erica Kholinne, MD, PhD
Hanif Fahmat, MD
Jefri Sukmawan, MD
Gede Chandra, MD
Renaldi Prasetia N. Rasyid, MD
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GENERAL INFORMATION
THEME : Advancing Arthroscopic Surgery in Orthopaedic Sports Injury
DATE : September 1st – 3rd , 2022
VENUE : Pullman & Ibis Styles Bandung Grand Central
SECRETARIAT
ORGANIZER
Indonesian Orthopedic Society for Sports Medicine and Arthroscopy (IOSSMA)
Gedung Menara Era, 8th Floor, Unit 8-04
Jl. Senen Raya No. 135 – 137, Senen – Jakarta Pusat 10410
Contact Person : Debi (0813 6134 4472)
Email : iossmasummit2022@gmail.com
CO ORGANIZER
PT. GPD Indonesia Pro
Jl. Kebalen V No.24A, Kebayoran Baru, Jakarta 12180
Phone : 021-725 4424 / 722 9339 , Fax : 021-739 6261
Contact Person : Erlin (08111 332 664 / 08111 662 664)
Desta (0818 920 664)
Email : erlin@gpdindonesia.com
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The 4th Congress And 10th Annual Meeting Of IOSSMA
INDONESIAN ORTHOPEDIC SOCIETY FOR SPORTS MEDICINE AND ARTHROSCOPY
FACULTY MEMBERS
Adisa Yusuf Reksoprodjo, MD - INA Isa An Nagib, MD - INA
Alvin Wiharja, MD - INA Jafri Hasan, MD - INA
Alvin Da Costa, MD - INA Jefri Sukmawan, MD - INA
Andi Nusawarta, MD - INA John CH.P. Butar-Butar, MD - INA
Andri MT Lubis, MD, PhD - INA L. Andre Pontoh, MD - INA
Arrisna Artha, MD - INA Langga Sintong , MD - INA
Ariyanto Arief, MD - INA Leonardo Lubis, MD - INA
Astuti Pitarini, MD - INA Lia Marliana, MD - INA
Athiyah Sulistiani, MD - INA Margaretta Silvia Yolanda, MD - INA
Atta Kuntara, MD - INA Muhammad Sakti, MD, PhD - INA
Bobby Nelwan, MD - INA Nadia Nastassia P. P. S. Ifran, MD - INA
Chanakarn Phornphutkul - THAI Peter Giarso, MD - INA
Charles Hoo, MD - INA Prof. Hermawan N Rasyid, MD, PhD - INA
Christian Silas, MD - INA Prof. Putu Astawa, MD, PhD - INA
Dave Lee - SIN R. Andri Primadhi, MD - INA
David Parker - AUS R. Permana Yudhadibrata, MD - INA
Didi Hertanto, MD - INA Renaldi Prasetia Nagar Rasyid, MD - INA
Dimas Radithya Boedijono, MD - INA Romy Deviandri, MD - INA
Erica Kholinne, MD - INA Ronny Sutanto, MD - INA
Erick Wonggokusuma, MD - INA Roni Lesmana, MD - INA
Evan, MD - INA Sapto Adji Hardjosworo, MD - INA
Fahroni Cahyono Winata, MD - INA Sigit Wedhanto, MD - INA
Gede Chandra Purnama Yudha, MD - INA Sumpada Priambudi, MD - INA
Ghuna Arioharjo Utoyo, MD - INA Taufin Warindra, MD - INA
Hanif Fahmat, MD - INA Troydimas Panjaitan, MD - INA
Henry Suhendra, MD - INA Wahyu Riansyah, MD - INA
Husnul Fuad Albar, MD - INA Yanuarso, MD - INA
Ihsan Oesman, MD - INA Yoshi Pratama Djaja, MD - INA
IGM Febry Siswanto, MD - INA Yudistira Siregar, MD - INA
IGN Wien Aryana, MD - INA
Iman W Aminata, MD - INA
Irma Ruslina Defi, MD - INA
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PROGRAM AT GLANCE
EVENT CALENDAR
DATE : September 1st - 3rd, 2022
Venue : Pullman & Ibis Styles Bandung Grand Central
DATES AGENDA
DAY 1 Thursday, September 1st, 2022 Symposium
DAY 3 Saturday, September 3rd, 2022 Cadaveric Workshop : Knee & Shoulder
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INDONESIAN ORTHOPEDIC SOCIETY FOR SPORTS MEDICINE AND ARTHROSCOPY
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PROGRAM AT GLANCE
TIME PULLMAN BALLROOM 1 PULLMAN BALLROOM 2
EVENT CALENDAR
07.00 - 16.00 REGISTRATION
PLENARY SESSION 1
General Sports, Anatomy & Biomechanics
08.00 - 09.10
Chairman: Idrus A Patirusi
Co-Chairman: Lia Marliana
DAY 3
09.10 – 09.15 Saturday, September
MC Opening 3 rd
, 2022 National Anthem
+ Indonesian Cadaveric
(IndonesiaWorkshop
Raya) : Knee & Shoulder
Highlights of Congress Programme
09.15 – 09.25
Wahyu Riansyah
President Address & Introducing Guest Speaker
09.25 – 09.35
Muhammad Sakti
Handover of IOSSMA President Position & Speech
09.35 - 09.40
Ghuna Utoyo
IOA address
09.40 - 09.50
IOA president (Edi Mustamsir) or Delegate
Welcome Note from Chairman of IDI
09.50 - 10.00
M. Adib Khumaidi
Opening Speech by Governor of Jawa Bawat (Tentative)
10.00 - 10.05
Ridwan Kamil, Mr
10.44 - 10.54 Morning Tea & Opening Exhibition Visit by President of IOSSMA
PLENARY SESSION 2
Knee
10.54 - 11.54
Chairman: Bobby Nelwan
Co-Chairman: Isa An Nagib
The Short graft ACL Reconstruction
10.54 - 11.06
Dave Lee (Singapore)
08
e 4The
th
Congress
4th Congress
And 10
And
th
Annual
10th Annual
Meeting
Meeting
Of IOSSMA
Of IOSSMA
ONESIAN
INDONESIAN
ORTHOPEDIC
ORTHOPEDIC
SOCIETY SOCIETY
FOR SPORTS
FOR MEDICINE
SPORTS MEDICINE
AND ARTHROSCOPY
AND ARTHROSCOPY
SYMPOSIUM 1 SYMPOSIUM 2
Shoulder session : Glenohumeral Instability Knee session : Anterior Cruciate Ligament (1)
13.24 - 14.24
Chairman: Iman Aminata Chairman: IGM Febry Siswanto
Co-Chairman: Troydimas Panjaitan Co-Chairman: Gede Chandra
Decision Making in Anterior Instability Surgery The holy grail of ACL graft
13.24 - 13.36
Erica Kholinne Andri MT Lubis
Open Bankart Surgery for Anterior Instability The ACL reconstruction : Get it Right First Time, Every Time
13.36 - 13.48
Hermawan Nagar Rasyid Christian Silas
Arthroscopic Bankart Repair: Surgical Pearls ACL reconstruction for open physes patient
13.48 - 14.00
Jefri Sukmawan Ghuna Utoyo
Multidirectional Shoulder Instability How to optimize return to sport in ACL surgery
14.00 - 14.12
Renaldi Prasetia Husnul Fuad Albar
14.12 - 14.24 Q&A Q&A
CLINICAL CASE PANEL SHOULDER CLINICAL CASE PANEL KNEE
Case Presenter / Moderator: Gede Chandra
14.24 - 15.09 Case Presenter / Moderator: Arrisna Artha
Panelist: IGM Febry Siswanto, Andri MT Lubis, Chanakarn
Panelist: Jefri Sukmawan, Renaldi Prasetia, Troydimas Panjaitan
Phornputkul, Dave Lee, Edgar Michael T. Eufemio
PLENARY SESSION 3
15.24 - 15.49 Debate 1 : Anterior Shoulder Instability
Chairman: Hermawan Nagar Rasyid
Arthroscopic Procedure
15.24 - 15.29
Erica Kholinne
Open Bone Block Procedure
15.29 - 15.34
Iman Aminata
vancing
"Advancing
Arthroscopic
Arthroscopic
Surgery
Surgery
in Orthopedic
in Orthopedic
SportsSports
Injury"Injury"
llman
Pullman
& IBIS Styles
& IBIS Styles
BandungBandung
Grand Grand
CentralCentral
September
September
1st - 3rd, 2022
1st - 3rd, 2022 09 09
for Sp o r for Sp o r
c ie t y ts c ie t y ts
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EVENT CALENDAR
07.00 - 16.00 REGISTRATION
SYMPOSIUM 3 SYMPOSIUM 4
Shoulder session : Shoulder Sports Injury Knee Session : Meniscus
08.00 - 09.00
Chairman: Jefri Sukmawan Chairman: Didi Hertanto
Co-Chairman: Erica Kholinne Co-Chairman: Charles Hoo
Meniscus Repair Versus Meniscectomy: Indication and
Acromioclavicular Joint Problems in Athletes
08.00 – 08.12 DATE Renaldi: Prasetia
September 1st - 3 , rd
2022 Outcome
Romy Deviandri
Venue : Pullman & Ibis Styles Bandung Grand Central
Pectoralis Major Injury Management of Discoid Meniscus
08.12 – 08.24
Arrisna Artha
DATES
Superior Labrum Anterior - Posterior (SLAP) Lesion
Speaker: Nadia Ifran
Hidden Meniscus Problems: Ramp Lesion and Posterior
AGENDA
08.24 – 08.36 DAY 1ConsiderationThursday, September
and Controversies 1st, 2022 MeniscusSymposium
Medial Root Tear
Troydimas Panjaitan John CH.P. Butar-Butar
Rotator Cuff Injury in Athletic Population Meniscus Surgery in Limited Resources Setting
08.36 – 08.48
DAY 2 Iman W. Aminata
Friday, September 2 , 2022 nd Peter Giarso
Symposium
08.48 – 09.00 Q&A Q&A
SYMPOSIUM 5 SYMPOSIUM 6
Hip Session Foot and Ankle Session
09.00 - 10.00 DAY 3
Chairman: Saturday,
WahyuriansyahSeptember 3 , 2022 Chairman: John
rd
Cadaveric Workshop
CH.P. Butar-Butar : Knee & Shoulder
Co-Chairman: Adisa Yusuf Reksoprodjo Co-Chairman: Margaretta Silvia Yolanda
Indication and Setting for Ankle
Hip Arthroscopy Setting : Pearls for Success 09.00 –
09.00 – 09.12 Arthroscopy
Sapto Adji 09.10
Dimas Radithya Boedijono
Everything about Hip Labrum The Ankle Impingement
09.12 - 09.24 09.10 - 09.20
Yoshi P Djaja Ihsan Oesman
Lateral Ankle Instability: Diagnosis and
The Management of Femoroacetabular Impingement 09.20 -
09.24 - 09.36 Treatment
Adisa Yusuf Reksoprodjo 09.30
Astuti Pitarini
Greater Trochanteric Pain Syndrome 09.30 - Medial Ankle Instability
09.36 - 09.48
Yoshi P Djaja 09.40 R. Andri Primadhi
09.40 - Syndesmotic Instability
09.48 - 10.00 Q&A
09.50 Langga Sintong
10
4th Congress
The 4th Congress
And 10thAnd
Annual
10th Annual
MeetingMeeting
Of IOSSMA
Of IOSSMA
ESIANINDONESIAN
ORTHOPEDICORTHOPEDIC
SOCIETY FORSOCIETY
SPORTSFOR
MEDICINE
SPORTSAND
MEDICINE
ARTHROSCOPY
AND ARTHROSCOPY
SYMPOSIUM 7
SYMPOSIUM 8
Knee Session : Multiligament injury & Patellofemoral
Knee Session : Anterior Cruciate Ligament 2
10.15 - 11.15 Instability
Chairman: Yudistira Siregar
Chairman: Muhammad Sakti
Co-Chairman: Wahyu Riansyah
Co-Chairman: Erick Wonggokusuma
Management of Multiligament Knee Injury Practical Approach to Address Failed ACL Surgery
10.15 - 10.27
Isa An Nagib IGN Wien Aryana
Management for Arthrofibrosis Following ACL
Implantless MPFL reconstruction
10.27 - 10.39 Reconstruction
Andre Pontoh
Speaker: Ronny Sutanto
Medial Patellofemoral Complex Reconstruction : How, Adding a Lateral Extraarticular Tenodesis to ACL
10.39 - 10.51 When & Why? Reconstructions in 2022
Chanakarn Phornphutkul Dave Lee (Singapore)
POL Reconstruction: a Necessity or an Accessory? High Tibial Osteotomy with ACL Reconstruction Free Paper / E -
10.51 - 11.03
Speaker: Bobby Nelwan Fahroni Cahyono Winata Poster Chairman :
Prof Putu Astawa /
11.03 - 11.15 Q&A Q&A
Nadia Nastassia Ifran
SYMPOSIUM 9 SYMPOSIUM 10 / Romy Deviandri /
Knee Session : Cartilage Restoration in Non Arthritic Knee Session : Anterior Cruciate Ligament 3 or Erica Kholinne
11.15 - 12.00 Knee MISCELLANOUS
Chairman: Hanif Fahmat Chairman: Sigit Wedhanto
Co-Chairman: Erick Wonggokusuma Co-Chairman: Christian Silas
When and What to Consider Knee Arthroscopy Surgery
How to Deal with Cartilage Lesions Based on the Size
11.15 - 11.27 in Post-COVID 19 Infected Patient
Taufin Warindra
R. Permana Yudhadibrata
Management of Cartilage Lesions Based on Etiology :
Ligament Injury Associated in Tibial Plateau Fracture
11.27 - 11.39 OCD versus Acute Traumatic Lesions
Ariyanto Arief
Athiyah Sulistiani
The Biologic Approach for Managing Cartilage Injury :
ACL Repair
11.39 - 11.51 Where are We Now?
Jafri Hasan
Evan
11.51- 12.00 Q&A Q&A
PLENARY SESSION 4
LIVE SURGERY TECHNIQUES SHOULDER
13.30 - 14.30
Chairman: Hermawan Nagar Rasyid
Co-Chairman: Erica Kholinne
13.30 - 14.30 Operating Surgeon : Renaldi Prasetia / Assisting Surgeon : Alvin Da Costa
PLENARY SESSION 5
LIVE SURGERY TECHNIQUES KNEE
14.45 - 16.45
Chairman : Ghuna Utoyo
Co-Chairman: Sumpada
14.45 - 16.45 Operating surgeon : Bobby Nelwan / Assisting Surgeon : Alvin Da Costa
ncing
"Advancing
Arthroscopic
Arthroscopic
SurgerySurgery
in Orthopedic
in Orthopedic
Sports Injury"
Sports Injury"
man &Pullman
IBIS Styles
& IBIS
Bandung
Styles Bandung
Grand Central
Grand Central
SeptemberSeptember
1st - 3rd, 2022
1st - 3rd, 2022 09 11
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The 4th Congress And 10th Annual Meeting IOSSMA 2022 Indonesian Orthopedic Society For Sports Medicine
and Arthroscopy “Advancing Arthroscopic Surgery in Orthopaedic Sports Injury”, will be held in Bandung, Indonesia
on September 1st – 3rd, 2022. Type of study can be ranging from case report and original article which can cover either
basic or clinical �ield in orthopaedic sport surgery. The abstract can be submitted start from February 1st, 2022.
Please follow the instructions for submitting the abstract below.
Format of Presentation
• E-Poster
• Oral Presentation
Abstract Categories
The committee will accept all abstract categories Abstract Acceptance Each abstract will be reviewed by the peer
reviewers. Abstract may be submitted as moderated posters or unmoderated posters.
Abstract Withdrawal
Please submit abstract withdrawal request in written from before August 15th, 2022.
Preparation of Abstracts
• Language
Abstract must be written and presented in English. Careful typing and proofreading is essential. Errors, misspellings,
incorrect hyphenation and deviations from the use of correct English cannot be changed once the abstract is submitted
• Size
The size of the abstracts is limited to 350 words.
• Title
The title should clearly de�ine the topic. Do not identify your institution in the title.
12
The 4th Congress And 10th Annual Meeting Of IOSSMA
INDONESIAN ORTHOPEDIC SOCIETY FOR SPORTS MEDICINE AND ARTHROSCOPY
• Authors
Type full family name and �irst name of all authors. It is advisable to check the correct spelling of the family and
initials of each authors.
• Submission
Deadline Deadline for abstract submission is August 15th, 2022. Please submit your abstract by email to
iossmasummit2022@gmail.com
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REGISTRATION FEE
All participants, including presenters of papers and presentation posters, must register as participants. Registration
fees include: access to all scientific classes, access to exhibition, symposium kits, lunch and coffee break..
TYPE OF REGISTRATION
• REGISTRATION BY EMAIL
Participants must complete and submit the registration form as required. After the submission of the application is
accepted, the participant then email the payment receipt. Registration statement will be ignored after 14 days
without payment. To get a registration form, contact the secretariat at +62 21 7254424 or +62 21 7229339. The
completed registration form should be emailed to erlin@gpdindonesia.com and iossmasummit2022@gmail.com
• REGISTRATION BY FAX
Complete the registration form to the Secretariat Fax number at +62 21 7396261 and then reconfirm to secretariat at
+62 21 7254424 or +62 21 7229339
• ONSITE REGISTRATION
Those who have not registered in advance may register at onsite registration desk. Cash payment in Rupiah will be
accepted during onsite registration. No refund will be made for onsite registration fees.
• ONLINE REGISTRATION
Make sure your internet connection is connected properly and sufficient to make the registration process. Online
registration process, it is highly recommended to use Fire Fox, Safari or Chrome. IE is not recommended. Complete all
the fields in the registration form, make sure there are no missing fields. Complete the �ield on the form of payment
with the same data on the registration form. Make sure there are no missing columns. If complete, continue the regis-
tration process by pressing “Register” button. Next you will receive a message to con�irm payment through the e-mail
address you specify.
CONFIRMATION OF REGISTRATION
Upon receipt of the registration form and the appropriate fees of receipt and registration of the of�icial con�irmation
will be sent. Please indicate the registration con�irmation at the registration table to get the participant’s identity and
symposium kit.
CANCELLATION OF REGISTRATION
1.Cancellation is submitted in writing and will be followed up after the congress is completed.
2.Written cancelation received before August 1st, 2022 refund of 50%, no refund thereafter.
3.Refund will be made 1 (one) month after the event is �inished.
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The 4th Congress And 10th Annual Meeting Of IOSSMA
INDONESIAN ORTHOPEDIC SOCIETY FOR SPORTS MEDICINE AND ARTHROSCOPY
HOTEL POLICY
Due to high demand on the hotel room at the time of congress, the committee strongly recommended early reserva-
tions. Hotel room reservation services depend on hotel room availability.
ROOM RATE
Hotel rooms at special congress rate are being held for the congress participants at Pullman & Ibis Styles Bandung
Grand Central. Room rates are in Rupiah, per night and per room included breakfast for two persons. Reservations
must be made through the congress secretariat to guarantee the indicated rate negotiates for the congress.
ACCOMMODATION REGULATION
1.Hotel room rate is net including 2 (two breakfasts).
2.Of�icial Check-in time is at 15.00 and check-out is at 12:00 in local time.
3.Approval early check-in and late check-out is the hotel’s policy.
4.Reservations cannot be made without full deposit of a number of nights booking based on room availability.
5.No show will be applied on the �irst night of the delay and will result in a loss of 1 night deposit.
6.For hotel services not included in the package, will be charged via personal account when check-out by the hotel
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Registration Form
Participant Data (Please Complete All Fields)
Academic Title : Prof Dr dr Specialist Other
Full Name :
Organization/Institution :
Mailing Address :
Country :
Zip Code :
Mobile Phone :
Email :
Sponsor :
Mobile Phone :
Please Mark (√) on Symposium you choose
NO PARTICIPANT Registration Fee
1 MEMBER IDR. 3.500.000
2 NON MEMBER IDR. 4.500.000
Others
3 Non Orthopedic Specialist IDR. 2.250.000
4 GP/Resident IDR. 1.500.000
5 Physiotherapist IDR. 1.500.000
TOTAL IDR.
Please Mark (√) on Workshop you choose
Registration Fee
NO WORKSHOP Date
Member Non Member
1 Cadaveric Workshop : Knee & Shoulder September 3rd ,2022 IDR. 11.500.000 IDR. 14.000.000
TOTAL IDR.
CANCELLATION AND REFUND POLICY
Written cancellation notice is required. Cancellation must be recevied before August 1st 2022 no refund
Bank Name : BTPN Branch Menara BTPN Jakarta Signature
Account Name : IOSSMA
Account Number : 0537 3 004581
Swift Code : SUNIIDJA
Please quote the sender’s name on the bank transfer statement
When transmitting, please make sure who send the money possibly by email
THIS FORM TOGETHER WITH REQUISITEMENT PAYMANET AND/OR DOCUMENTATION SHOULD BE EMAILED/FAXED TO SECRETARIAT
Phone : 021 7254424, +62 21 7229339, 0813 6134 4472 (Debi), 08111 332 664 / 08111 662 664 (Erlin), 0818 920 664 (Desta),
Fax : 021 7396261
Email : erlin@gpdindonesia.com | iossmasummit2022@gmail.com
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INDONESIAN ORTHOPEDIC SOCIETY FOR SPORTS MEDICINE AND ARTHROSCOPY
Accommodation Form
Participant Data (Please Complete All Fields)
Academic Title : Prof Dr dr Specialist Other
Full Name :
Organization/Institution :
Mailing Address :
Country :
Zip Code :
Mobile Phone :
Email :
Sponsor :
Mobile Phone :
Please Mark (√) on Hotel you choose
TOTAL IDR.
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Hotel Room
Pullman Hotel
18
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In y
2012
ty for S p o r ts
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In y
2012