PROPOSAL

JAKARTA UPDATE ON Gynecology Obstetrics 2

 Dear Partners and Exhibitors,

On behalf of all Jakarta Updated Gynecology

and Obstetrics 2 (Jak Up and GO 2)
committee members, we would like to extend
our warmest welcome to your company in order
to take part in our event. Our yearly program will
be held on 30th January - 2nd February 2019 in
Double Tree Hotel by Hilton, Jakarta.

This event will be attended by ±400 participant,

OBGYN specialist, general practitioner, and
midwives who are competent in their own field
Suskhan Djusad of profession.
Department Head of Obstetric and Gynecology FKUI-RSCM

We hope to improve participants' depth of

knowledge and their clinical skill through this
event. Also, we aspire to build further
collaboration between your company and doctor
as well as other health institutions. We will see
you in Jak Up and GO 2

JAKARTA
UPDATE ON
GYNECOLOGY
AND
OBSTETRICS
JANUARY 30th - FEBRUARY 2nd
Double Tree Hotel by Hilton Jakarta
 COMMITTEE
MEMBERS
Chairman : Andi Darma Putra

Deputy Chairman : M Dwi Priangga

Secretary : Gita Nurul Hidayah

Scientific Committee : Junita Indarti

Fitriyadi Kusuma
Hariyono Winarto
Achmad Kemal Harzif
Tyas Priyatini
Rima Irwinda
Alfa Putri Meutia

Event Committee : Kartiwa Hadi Nuryanto

M. Adya Firmansha Dilmy

Publication & : Riyan Hari Kurniawan

Documentation Wiwiek Kartika
Committee

Treasurer : Budi Wiweko

Tofan Widya Utami
Arietta D Pusponegoro
Cepi Teguh P
Secretariat
Jakarta Update on
Gynecology and Obstetrics 2
(Jak Up ‘n Go 2) – 2019
Obstetric and Gynecology Department
FKUI-RSCM

Diponegoro Raya St. No 71 Central Jakarta

Handphone : 0821 1150 5591 (Anni)
0813 2247 4649 (Fenny)
Fax : (021) 3918620
E-mail : bedahginekologi@yahoo.com
kampusobgyn@gmail.com
 PROGRAM DATE PARTICIPANTS LOCATION

Advanced Obstetric & Gynecologic OBYGN Hotel Double Tree

30th - 31st January 2019
Ultrasound course by Hilton

Update on Advanced Live and OBYGN RSUPN

30th - 31st January 2019
Hands-on Colposcopy dr. Cipto Mangunkusumo

LESS (Laparo-Endoscopic Single

30th January 2019 OBYGN RSMC Kintani
Site Surgery)

Current Progress Update of abnormal OBYGN Hotel Double Tree

30th January 2019
Invasive Placenta Management by Hilton

OBYGN RSUPN
Hysteroscopy 31st January 2019
dr. Cipto Mangunkusumo

Update on Basic Neonatal and General Practitioners, RSUPN

31st January 2019
Obstetric Emergency Management Midwife,OBYGN dr. Cipto Mangunkusumo

General Practitioners, Hotel Double Tree

Jak up n Go Symposium 1st – 2nd February 2019
Midwife,OBYGN by Hilton

Time and place:

Date : Wednesday – Saturday ,,
30 th January - 2 nd February 2019

Place : RSUPN dr. Cipto Mangunkusumo

Pangeran Diponegoro St. No. 71, RW. 5 Kenari, Central Jakarta,
Special Capital Region of Jakarta, Jakarta 10430

RSCM Kintani
Raden Saleh Raya St. No. 1, RT.1/RW4, Cikini, Central Jakarta,
Special Capital Region of Jakarta, Jakarta 10330

DoubleTree Hotel by Hilton Jakarta

Pegangsaan timur St. No. 17 RT.10/RW.1, Cikini, Menteng,
Central Jakarta,Special Capital Region of Jakarta, Jakarta 10310
Phone: (021) 31904433
 1. Achmad Kemal Harzif
2. Alfa P. Meutia

SPEAKERS
3. Andi Darma Putra
4. Andon Hestiantoro
5. Andrijono
6. Aria Wibawa
7. Arietta D. Pusponegoro
8. Azen Salim
9. Budi Iman Santoso
10. Budi Wiweko
11. Cepi Teguh Pramayadi
12. Damar Prasmusinto
13. Dwiana Ocviyanti
14. Endy M Moegni
15. Eka Rusdianto
16. Fernandi Moegni
17. Fitriyadi Kusuma
18. Gita Nurul Hidayah
19. Gita Pratama
20. Hariyono Winarto
21. Herbert Situmorang
22. IPG Kayika
23. J.M. Seno Adjie
24. Junita Indarti
25. Junizaf
26. Kanadi Sumapradja
27. Luky Satria
28. M. Adya Firmansha Dilmy
29. M. Dwi Priangga
30. Noroyono Wibowo
31. Omo Abdul Madjid
32. Rima Irwinda
33. Riyan Hari Kurniawan
34. Sigit Purbadi
35. Suskhan Djusad
36. Surahman Hakim
37. T. Dewi Anggraeni
38. Tofan Widya Utami
39. Tyas Priyatini
40. Wachyu Hadisaputra
41. Yudianto Budi Saroyo
42. Yuditiya Purwosunu
 Workshop | Advanced Obstetric & Gynecologic Ultrasound
“Role of Ultrasound in The Great Obstetric Syndrome”
Day 1 | Wednesday, January 30th 2019 | Double Tree Hotel by Hilton Jakarta

Time Topics Speakers

07.00 – 08.00 Registration
08.00 – 08.30 Role of Ultrasonography on Risk Noroyono Wibowo
Stratification of Pregnancy
08.30 - 09.00 Application of Radiant Flow and HD Azen Salim
Flow, in Evaluation of Structure and
Function of Fetal Heart
09.00 - 09.30 Role of USG in Monitoring the Risk of Rima Irwinda
Preterm Labor

Session 1 (Advanced Obstetric Ultrasound I): Preterm & IUGR

Moderator : Rima Irwinda
09.30 - 10.00 Elastography Ultrasonography and its Azen Salim
Potential Application in Predicting
Preterm Labor
10.00 - 10.30 Coffee Break

10.30 - 11.00 Role of Doppler in Evaluation & Yuditiya Purwosunu

Monitoring of Fetus with Intra-uterine
Growth Restriction (IUGR)
11.00 - 11.30 Neurobehavior Evaluation in Fetus Noroyono Wibowo
with Growth Disorder
11.30 - 11.40 Discussion

Session 2 (Advanced Obstetric Ultrasound II): Specific Anatomic Scan

Moderator : Yudianto B Saroyo
11.40 - 12.10 Assessment of Cerebral Placenta Ratio Aria Wibawa
(CPR) Doppler in Evaluation of
Pregnancy with Uteroplacental
Insufficiency
12.10 - 13.10 Lunch Break
13.10 - 13.40 Role of Fetal Ductus Venosus and Aria Wibawa
Isthmus Aortic Doppler Evaluation in
Consideration of Pregnancy
Termination
13.40 - 14.10 Application of Viewpoint as a Helpful Noroyono Wibowo
Instrument in Consideration of
Intervention for Woman with High Risk
Obstetric Syndrome
14.10 - 14.40 Mapping of Abnormally Invasive Noroyono Wibowo
Placenta

14.40 - 15.00 Discussion

15.00 - 15.30 Coffee Break

 Workshop | Advanced Obstetric & Gynecologic Ultrasound
“Role of Ultrasound in The Great Obstetric Syndrome”
Day 2 | Thursday, January 31st 2019 | Double Tree Hotel by Hilton Jakarta

Time Topics Speakers

08.00 - 08.30 Ultrasonography of Complicated Andi Darma Putra
Gynecologic cases
08.30 - 09.00 Role of Ultrasonography in Andi Darma Putra
Management of Uterine Leiomyoma

09.00 - 09.10 Discussion

09.10 - 09.40 Coffee Break

Session 1 (Advanced Gynecologic Ultrasound I)

Moderator : Tofan Widya Utami
09.40 - 10.10 Role Ultrasonography in The Infertility Gita Pratama
Work Up
10.10 - 10.40 Ultrasound Diagnosis of Pelvic Andi Darma Putra
Tuberculosis from Indonesian
Experience

10.40 - 11.10 Ultrasound Scan of the Uterus & Cervix T. Dewi Anggraeni
11.10 - 11.20 Discussion

Session 2 (Advanced Gynecologic Ultrasound II)

Moderator : Achmad Kemal Harzif
11.20 - 11.50 Comprehensive Endometriosis Scans Kanadi Sumapradja
11.50 - 13.00 Lunch Break
13.00 - 13.30 Ultrasound Diagnosis of Complex Fernandy Moegni
Mullerian Abnormalities (OmniView)
13.30 - 14.00 IOTA ADNEX Index Andi Darma Putra
14.00 - 16.00 Live Demo Andi Darma Putra
16.00-16.30 Coffee Break
 Workshop | Update on Advanced Colposcopy
“Live and Hands-on ”
Day 1 | Wednesday, January 30th 2019 | RSUPN Dr. Cipto Mangunkusumo

Time Topics Speakers

07.00 – 08.00 Registration
08.00 - 08.10 Opening
08.10 - 08.30 Pre-test
08.30 - 09.15 Why should we do Colposcopy? Endy M. Moegni
- Is it still Important?
- Colposcopy Versus IVA
- Medicolegal Aspects of Colposcopy
09.15 - 10.00 Pitfalls in Cervical Cytology Junita Indarti
10.00 - 10.30 Coffee Break
10.15 - 11.00 Nomenclature & Understanding Dwiana Ocviyanti
Colposcopy :
- Pathophysiology of White Epithelium
Formation
11.00 - 12.00 Abnormal Colposcopy Findings and Fitriyadi Kusuma
Pitfalls in Colposcopy :
- Imaging Differences between IVA
and Colposcopy
12.10 - 13.10 Lunch Break
13.00 - 14.00 Precancerous Lesions and Their Endy M. Moegni
Treatments
14.00 - 15.00 Video Session: Preparing and Dwiana Ocviyanti
Performing Colposcopy
- Colposcopy demo in patient by
consultant, integrated with femicam

15.00 - 15.15 Coffee Break

15.15 - 15.30 Discussion and Q&A

 Workshop | Update on Advanced Colposcopy
“Live and Hands-on ”
Day 2 | Thursday, January 31st 2019 | RSUPN Dr. Cipto Mangunkusumo

Time Topics Speakers

08.00 - 10.00 Practice: Colposcopy on Model Colposcopy Trainers
10.00 - 10.15 Coffee Break
10.15 - 12.30 Practice: Colposcopy on Patient Colposcopy Trainers
12.30 - 13.30 Lunch Break
13.30 - 15.00 Practice: Colposcopy on Patient Colposcopy Trainers
15.15 - 15.30 Discussion and Q&A

15.30 - 16.00 Feedback, Closing ceremony All of The Staff

 Workshop | Single Port Laparoscopy
“LESS (Laparo-Endoscopic Single Site Surgery)”
Thursday, January 31st 2019 | RSCM Kintani

Time Topics Speakers

07.00 – 08.00 Registration
08.00 – 08.30 Opening Fitriyadi Kusuma
Symposium I
Moderator : Riyan Hari Kurniawan
08.30 - 09.00 LESS in Gynecology: Advanced Sigit Purbadi
Minimally Invasive Surgery (History of
LESS)
09.00 - 09.30 LESS vs Conventional Laparoscopy Fitriyadi Kusuma
09.30 - 10.00 Training for LESS Herbert Situmorang
10.00 - 10.30 Coffee Break

Symposium II
Moderator : Cepi Teguh Pramayadi

10.30 - 11.00 LESS for Adnexal Surgery Hariyono Winarto

11.00 - 11.30 LESS for Myomectomy Luky Satria
11.30 - 12.00 LESS for Hysterectomy T.Dewi Anggraeni
12.00 - 13.00 Lunch Break

Video Session
Moderator : Alfa Putri Meutia

13.00 - 13.30 Adnexal Surgery Team

13.30 - 14.00 Myomectomy Team
14.00 - 14.30 Hysterectomy Team

14.30 - 14.45 Closing ceremony Fitriyadi Kusuma

14.45 - 15.00 Coffee Break

 Workshop | Current Progress Update of Abnormally
Invasive Placenta Management
Day 1 | Wednesday, January 30th 2019 | Double Tree Hotel by Hilton Jakarta

Time Topics
07.00 – 08.00 Registration
08.00 - 08.20 Role of POGI in Depreciating the Rate of Complication and
Maternal Mortality due to Post-term and Post-partum
Hemorrhage due to Abnormal Placental Invasion in Indonesia
08.20 - 08.40 Development of Global Problem Approach in Increasing Rate
of Abnormal Placental Invasion in the World (FIGO
Recommendations)
08.40 - 09.00 Roadmap to Comprehensive Management of Abnormal
Placental Invasion
09.00 - 09.20 Characteristics of Abnormal Invasive Placenta Cases in
FKUI-RSCM
09.20 - 09.40 Anatomy Review: Pelvic Vascularization in Abnormal Placental
Implantation
09.40 - 10.00 Variety of Collateral Vascularization in Abnormal Invasive
Placenta
10.00 - 10.30 Coffee Break

10.30 - 10.50 Discussion

10.50 - 11.10 Role of Ultrasonography in Diagnosis of Abnormal Placental
Invasion
11.10 - 11.30 Role of MRI in Diagnosis of Abnormal Placental Invasion
11.30 - 11.50 Conservative Management of Abnormal Placental Invasion
(Conservative Surgery of Placenta Accreta in RSCM-FKUI)
11.50 - 12.10 When is The Right Time for Conservative or Radical
Management in Abnormal Placental Invasion?
12.10 - 13.10 Lunch Break
13.10 - 13.30 Can Abnormal Placental Invasion be Prevented?
13.30 - 13.50 Experience in Management of Abnormal Placental Invasion
Cases in Central Java
13.50 - 14.10 Experience of Accreta Team in Network Hospital of FKUI - 1 in
Management of Abnormal Placental Invasion
14.10 - 14.30 Experience of Accreta Team in Network Hospital of FKUI - 2 in
Management of Abnormal Placental Invasion
14.30 - 14.50 Conclusion and Proposed Algorithm for Management of
Abnormal Invasive Placenta
14.50 - 15.00 Discussion

15.00 - 15.30 Coffee Break

 Workshop |
Hysteroscopy
Thursday, January 31st 2019 | RSUPN Dr. Cipto Mangunkusumo

Time Topics Speakers

07.00 – 08.00 Registration
08.00 - 08.10 Opening
08.10 - 08.20 Pre-Test
08.20 - 08.40 Development of Shifting Paradigm of Achmad Kemal Harzif
Hysteroscopy Service from time to
time
08.40 - 09.00 Media Distension of Hysteroscopy Alfa P Meutia
Instrumentation and Clinical Room
Management
09.00 - 09.20 Step by Step Office Hysteroscopy Gita Pratama
09.20 - 09.40 Role of Hysteroscopy in Detection of T. Dewi Anggraeni
Endometrial Disorder
09.40 - 09.50 Discussion

09.50 - 10.20 Coffee Break

10.20 - 11.00 Interactive Video Tutorial Herbert Situmorang
- Endometrium Atrophy
- Abnormal Uterine Bleeding (AUB)
- Endometriosis
- Asherman’s syndrome
- Foreign body removal
11.00 - 11.20 Complication during Hysteroscopy Cepi Teguh
(Video)
11.20 - 12.20 Office Hysteroscopy (Live Demo) Herbert Situmorang

12.20 - 13.30 Lunch Break

13.30 - 15.00 Hands-on Model T.Dewi Anggraeni h
- Assembling and Dismantling Gita Pratama
- Diagnostic and Dismantling Herbert Situmorang
- Diagnostic Hysteroscopy Achamd Kemal Harzif
- Simple Office Hysteroscopy Procedure Cepi Teguh
- Myoma resection simulation Alfa P Meutia
Riyan Hari K
M. Dwi Priangga
Gita Nurul Hidayah
15.00 - 15.15 Post-Test
15.15 - 15.30 Closure
 Workshop | Update on Basic Neonatal and Obstetric
Emergency Management
Thursday, January 31st 2019 | RSUPN Dr. Cipto Mangunkusumo

Time Topics Speakers

07.00 – 08.00 Registration
08.00 - 08.15 Opening Speech by Chairperson Andi Darma Putra
Jak Up and GO 2
08.15 - 08.30 Opening Speech by Head of Suskhan Djusad
Obstetric and Gynecology
Department RSUPNCM FKUI

08.30 - 08.50 Ethics in Obstetric Service Omo Abdul Madjid

08.50 - 09.10 Excellent Antenatal Care and Team Dwiana Ocvyanti
Work in Maternal-Neonatal Emergency
09.10 - 09.30 CTG Interpretation Made Easier Arietta Pusponegoro
09.30 - 09.50 CTG Interpretation Exercise Tim Pelatih
09.50 - 10.00 Discussion

10.00 - 10.30 Coffee Break

10.30 - 10.50 Stabilization and Early Management of Arietta Pusponegoro
Post-Partum Management
10.50 - 11.10 Stabilization and Early Management of JM Seno Adjie
Neonatal Asphyxia
11.10 - 11.40 Exercise: Post-Partum Management Tim Pelatih
11.40 - 12.10 Exercise: Management of Neonatal Tim Pelatih
Resuscitation
12.10 - 13.10 Lunch Break
13.10 - 13.30 MEC Wheel as Practical Guiding Yudianto BS
Instrument in Contraception
Counselling
13.30-13.50 Review: MKJP and IUD Placement JM Seno Adjie
Technique after Post Placental Delivery

13.50 - 14.00 Discussion

14.00 - 14.30 Exercise: IUD Placement Post-Partum Tim Pelatih
14.30 - 14.50 Breaking Bad News Technique: IPG Kayika
Unexpected Outcome
14.50 - 15.10 Role Play: Delivery of Bad News

15.15 - 15.30 Closure & Coffee Break

 Symposium
Jak Up n GO
Day 1 | Thursday, February 1st 2019 | RSUPN Dr. Cipto Mangunkusumo

Time Topics Speakers

07.00 – 08.00 Registration
08.00 - 08.10 Opening Andi Darma Putra
08.10 - 08.20 Opening Speech by Head of Suskhan Djusad
Obstetric & Gynecology Department
FKUI RSCM
08.20 - 08.50 Main Lecture 1 The role of Arrietta D. Pusponegoro
professional in ethical mediation
ethics - medicolegal
08.50 - 09.20 Main Lecture 2 Pros & Cons of Naroyono Wibowo
Pharmacologic management in
pregnancy (aspirin, pravastatin,
isoprinosine, folic acid, zinc, iron)
09.20 - 09.50 Main Lecture 3 Algorithm at cervical Andrijono
cancer screening: Is there any update?

09.50 - 10.20 Coffee Break

Symposium - 1: Hot topics in Urogynecology

10.20 - 10.50 Pros and Cons: Made of Delivery for
subsequent pregnancy after OASIS
repair:
- Elective CS Alfa P. Meutia
- Vaginal Delivery Surahman Hakim
10.50 - 11.20 Sexual function after gynecologic Budi Iman Santoso
surgery
11.20 - 11.30 Discussion

11.30 - 12.30 Friday Prayer

12.30 - 13.30 Lunch Symposium 1 Advanced diagnostic &

treatment approaches in obstetrics
Moderator : M. Adya Firmansha Dilmy
- Cell-Free DNA (NIPS) Yuditiya Purwosunu
- Is there still a place for invasive Aria Wibawa
diagnosis procedures
(CVS/amnio/cardiocentesis) in
modern obstetrics?
Symposium - 2: Gynecology Malignancy in Daily Clinical Settings
13.30 - 13.50 Case Study: USG Imaging, Andi Darma Putra
Intraoperative findings, and
Histopathology of Tumor Adnexa
13.50 - 14.10 Case Study: Clinical imaging, USG and Fitriyadi Kusuma
monitoring of post mola pregnancy
evacuation
 Time Topics Speakers
14.10 - 14.30 Case study: Clinical findings, imaging Hariyono Winarto
and histopathology of endometrial
malignancy which can be managed by
obstetric and gynecology specialist

14.30 - 14.40 Discussion

Symposium - 3: Endometriosis
14.40 - 15.10 How to perform USG on endometriosis Kanadi Sumapradja
& adenomyosis
15.10 - 15.30 Strategy to choose treatment for Andon Hestiantoro
endometriosis in teenagers
15.30 - 15.50 When does operative procedures can Achmad Kemal Harzif
be done in endometriosis case with
infertility
15.50 - 16.30 Coffee Break

Symposium Closure Day-1

 Symposium
Jak Up n GO
Day 2 | Saturday, February 2nd 2019 | Double Tree Hotel by Hilton Jakarta

Time Topics Speakers

08.00 - 08.30 Ethics on Gynecology Clinical Practice Junizaf
08.30 - 09.00 Main Lecture - 4: Unexplained Kanadi Sumapradja
Recurrent Pregnancy Loss: What to do?
09.00 - 09.30 Main Lecture – 5: Strategy for equal Wachyu Hadisaputra
distribution of laparoscopic service in
Indonesia
09.30 - 09.45 Coffee Break

Symposium - 4 Functional Aesthetics in Gynecology

Moderator : Gita Nurul Hidayah
09.45 - 10.05 Laser vaginal rejuvenation: More than Fernandi Moegni
just aesthetics
10.05 - 10.25 Labia-vaginoplasty: Aesthetics or Suskhan Djusad
reconstruction?
10.25 - 10.45 Female Sexual Function after Tyas Priyatini
Reconstruction Surgery

10.45 - 11.00 Discussion

Symposium - 5 Counselling on Cases with Social Complications

Moderator : IPG Kayika

11.00 - 11.20 Pregnancy during extreme age: J.M. Seno Adjie

Too young and too old
11.20 - 11.40 Pre-conception ethical counselling for Omo Abdul Madjid
couple with congenital disease
11.40 - 11.55 Discussion

11.55 - 13.25 Lunch Break

Case study: Management of AUB Gita Pratama
Simple Protocol and Stimulation Budi Wiweko
Monitoring of Ovarium
Symposium – 6 Contraception
13.25 - 13.45 How to deal with medical barrier in Yudianto Budi Saroyo
contraception service?
13.45 - 14.05 LNG-IUS: Why is it important? Herbert Situmorang
14.05 - 14.25 Progestin-only pill: A new generation Eka Rusdianto

14.25 - 14.40 Discussion

14.40 - 15.25 Coffee Break

Symposium - 7: Nutritional Intervention

 Time Topics Speakers
15.25 - 15-45 Role of Vitamin D during Rima Irwinda
preconception, conception, and
pregnancy

15.45 - 16.05 DHA & Omega 3 and their role in Damar Prasmusinto
prevention of the Obstetric syndrome
16.05 - 16.25 Monitoring and intervention of Aria Wibawa
Intrauterine Growth Retardation

16.25 - 16.40 Discussion

 Sponsorship
Opportunities
at the Event
Lunch Symposium IDR 75.000.000

Symposium per Session IDR 65.000.000

Main Lecture IDR 55.000.000

Booth Space (3x2) IDR 55.000.000

Program Book IDR 50.000.000

Conference Bag IDR 20.000.000

Name tag & Certificate IDR 30.000.000

SPONSORSHIP INFORMATION

Lunch symposium
1. Presentation during one session (30 minute) with one speaker appointed by committee but the
topic will be discussed with the sponsor
2. Promotion of company logo on the side screen (one screen) in the meeting room
3. Distribution of company brochure
4. The name of the company will be exposed on the list of sponsors
5. The speaker and moderator’s honorarium will be covered by the sponsor (the amount should be
discussed with the speaker, the minimum should be satisfied to the amount the committee
regulation) the foreign speaker(s) accommodation, transportation and honorarium will be
covered by sponsor; the speakers are allowed to promote the products of sponsor
6. Lunch symposium will be attended by all participants

Symposium per session

1. Presentation during one session (30 minute) with one speaker appointed by committee but the
topic will be discussed with the sponsor
2. Promotion of company logo on the side screen (one screen) in the meeting room
3. Distribution of company brochure
4. The name of the company will be exposed on the list of sponsors
5. The speaker and moderator’s honorarium will be covered by the sponsor (the amount should be
discussed with the speaker, the minimum should be satisfied to the amount the committee
regulation) the foreign speaker(s) accommodation, transportation and honorarium will be
covered by sponsor; the speakers are allowed to promote the products of sponsor

Space for Booth

We only provide the space 3mx 2m, due to technical reasons, the logistic of the booth will be
borne to the tenant
 Please Kindly
Transfer to:

Bank : Bank Mandiri, RSCM

Jl. Diponegoro No. 71, Jakarta 10430, Indonesia
Acc. Name : Bagian Obstetri dan Ginekologi
Acc. Number : 122-008-3000-326

Please indicate your company desire level of sponsorship and provide the name and address
of the person to be contact :
Name : ................................................................................................................................................
Position : ................................................................................................................................................
Company : ................................................................................................................................................
Address : ................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
Phone/Fax : ................................................................................................................................................
Mobile Phone : ................................................................................................................................................
Email : ...............................................................................................................................................
On behalf of the company i represented above, i sign the confirmation letter in participating in
Jak Up n Go 2, 30th January – 2nd February 2019

No. Sponsorship IDR Remark

Total
JAKARTA
UPDATE ON
GYNECOLOGY Contact Person:
AND +62 821 1150 5591 (Anni)
OBSTETRICS 2 +62 813 2247 4649 (Fenny)
JANUARY 30th - FEBRUARY 2nd
(021) 3918620
Double Tree Hotel by Hilton Jakarta

bedahginekologi@yahoo.com ( Signature and Full Name)

kampusobgyn@gmail.com Note :
- Company that has filled confirmation forms means sponsorship agreement
- No cancellation for the sponsorship agreement
 BOOTH MAPPING

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ROOM C

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COOFFEE BREAK
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ROOM A

JAKARTA
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17 18 19 20 UPDATE ON
GYNECOLOGY
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AND
OBSTETRICS 2
IN

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1 2 JANUARY 30th - FEBRUARY 2nd

Double Tree Hotel by Hilton Jakarta

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