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PANITIA 1st PALEMBANG NEUROLOGY UPDATE 2014

BAGIAN/DEPARTEMEN NEUROLOGI
Fakultas Kedokteran Universitas Sriwijaya/RS. Dr. Moh. Hoesin Palembang
Alamat: Jalan Jenderal Sudirman KM. 3,5 Palembang
No. Telepon/Fax: (0711) 367660, e-mail: palneuro2014@gmail.com

SURAT PERMINTAAN DANA


No
:
Perihal : Pengajuan Dana Operasional

Palembang,

20

Kepada Yth.
Seksi Dana Usaha/Bendahara
Panitia 1st Palembang Neurology Update 2014
ditempat.

Dengan hormat,
Kami yang bertanda tangan di bawah ini, ....................................................................................... dari
Seksi ..................................................................................... Panitia 1st Palembang Neurology Update 2014,
mengajukan permohonan dana operasional sebesar: Rp ............................................................................
(terbilang ............................................................................................................. ), dengan rincian penggunaan
sebagai berikut:
No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Penggunaan

Jumlah

.........................................................
.........................................................
.........................................................
.........................................................
.........................................................
.........................................................
.........................................................
.........................................................
.........................................................
.........................................................

@ ...................
@ ...................
@ ...................
@ ...................
@ ...................
@ ...................
@ ...................
@ ...................
@ ...................
@ ...................

TOTAL

X
X
X
X
X
X
X
X
X
X

...................
...................
...................
...................
...................
...................
...................
...................
...................
...................

=
=
=
=
=
=
=
=
=
=

Rp. ............................
Rp. ............................
Rp. ............................
Rp. ............................
Rp. ............................
Rp. ............................
Rp. ............................
Rp. ............................
Rp. ............................
Rp. ............................
Rp.

Atas bantuan dan kerjasamanya, terima kasih.


Hormat kami,

(................................................)

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