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His statement, should be as valid and legal as the original. KARYAWAN / EMPLOYEE Tempat & Tanggal / Place & Date Tandatangan & nama / Signature & Name PT. Asuransi Jiwa Generali Indonesia Cyber 2 Tower 30th Fl. Jl. HR-Rasuna Said Blok X-5 No. 13, Jakarta 12950 Telp : 62-21 2996 3737, Fax : 62-21 29021717, Email : cs generali.co.id SURAT KETERANGAN DOKTER / ATTENDING PHYSICIAN S STATEMENT Apakah pasien dirawat inap? Did the patient hospitalize? Ya, indikasi rawat inap / Yes, indication of.

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