INDONESIAN SOCIETY OF HYPERTENSION

( Perhimpunan Dokter Hipertensi Indonesia )

Secretariat :
PERKI HOUSE Building 2nd Floor
Jl. Danau Toba 139 A-C, Bendungan Hilir Jakarta Indonesia
Tel : 62-21-5734978, Fax : 62-21-5734978
E-Mail : inash@inash.or.id; Website:
www.inash.or.id

CONFIRMATION LETTER
Regarding the 11th Scientific Meeting of the Indonesian Society of
Hypertension (InaSH) on February 24 26, 2017 in Sheraton Grand,
Jakarta; Herewith, I would like to confirm the acceptance of invited speaker /
moderator:

Name
:
_______________________________________________________________________

Lecture 1
Role

: Speaker

Topic

Moderator

(kindly circle the role)

_______________________________________________________________________

Lecture 2

(if there is)

Role

: Speaker

Topic

Moderator

(kindly circle the role)

_______________________________________________________________________

Acceptance:
I Agree

I Regret

Kindly send this confirmation letter back to the secretariat via Email:
scientific@inash.or.id or Fax: +62 21 5734978 at the latest on December 2,
2016

___________________________
Signature