en scb 2014 7 31 siloam hospitals waiting for growth acceleration in 2h14

l Equity Research l

Indonesia l Health Care

31 July 2014

Siloam Hospital Internasional
Waiting for growth acceleration in 2H14
 Siloam’s revenue growth 2Q14 was in line with our and IN-LINE (unchanged)
consensus estimates. However, net profit came in below
PRICE as of 25 Jul 2014
our forecast, due to weaker-than-expected margins at some
IDR 14,300
of its key hospitals.
 We maintain our In-Line rating and cut our price target to
IDR 15,100 (IDR 15,137 earlier). We reduce our 2014/15E
earnings by 9%/4% to reflect our tempered margin
expectations.

Bloomberg code


 Siloam trades at 22.4x 2015E EV/EBITDA and our price
target offers 6% upside potential.

EPS adj. est. change 2014E

2Q14 results meet consensus. Revenue was in line with our and

Year-end: December
Sales (IDR bn)
EBITDA (IDR bn)
EBIT (IDR bn)
Pre-tax profit (IDR bn)
Net profit adj. (IDR bn)
FCF (IDR bn)
EPS adj. (IDR)
DPS (IDR)
Book value/share (IDR)
EPS growth adj. (%)
DPS growth (%)
EBITDA margin (%)

EBIT margin (%)
Net margin adj. (%)
Div. payout (%)
Net gearing (%)
ROE (%)
ROCE (%)
EV/sales (x)
EV/EBITDA (x)
PBR (x)
PER adj. (x)
Dividend yield (%)

consensus estimates, accounting for 22% and 23%, respectively,
of full-year estimates. Net profit was in line with consensus (22% of
2014 estimates), but met only 16% of our full-year figure. Our initial
forecasts exceeded consensus, because we expected greater
operating leverage – as eight new hospitals (2012-13 vintage)
ramp up this year – and lower finance costs in 2014. We think
Siloam could still deliver strong 42% YoY revenue growth in 2014.
Mixed margin performance in 2Q14. Siloam’s overall 2Q14

EBITDA margin of 12.0% was below our expectation of 14.2%.
EBITDA margins at two mature hospitals, Kebon Jeruk and
Surabaya, were 3-5ppt weaker QoQ at 13-15% in 2Q14, compared
to 16-20% in 1Q. Similarly, EBITDA margin at the Mochtar Riady
Comprehensive Cancer Centre (MRCCC) was lower than expected
at 2.2% in 2Q14 (1H14: 5.5%), compared with our assumption of
13-16% in 2014. Based on our margin assumption adjustments, we
lower our 2014-15E EBITDA margin by 20-30bps, translating into a
2-7% cut in our 2014-15E earnings.

Reuters code

SILO.JK

Market cap

12-month range

IDR 14,972.7bn (USD 1,293mn)


IDR 9,050 - 15,150
-9.2%

2013
2,504
281
79
72
50
(409)
48
5
1,565
-5.6
nm
11.2
3.1
2.0
10.0
-27.8

5.3
4.3
4.1
36.1
6.1
209.2
0.0

2015E

2014E
3,548
495
192
155
109
(512)
94
9
1,505

97.7
97.7
13.9
5.4
3.1
10.0
15.3
6.4
7.7
4.7
34.0
9.5
151.9
0.1

-4.3%

2015E
5,186
783

338
243
171
(622)
148
22
1,635
57.2
135.8
15.1
6.5
3.3
15.0
53.6
9.4
11.3
3.4
22.4
8.7
96.6

0.2

2016E
7,434
1,194
606
439
309
(397)
267
53
1,857
80.8
141.0
16.1
8.2
4.2
20.0
70.9
15.3

16.8
2.4
15.1
7.7
53.5
0.4

Source: Company, Standard Chartered Research estimates

Share price performance

16,000

in 1H14 amounted to IDR 24bn (66% of our 2014 estimate). We
increase our effective interest rate assumption by 100bps to 12.5%
in 2014 and 11.5% in 2015. This adjustment accounts for the
remaining 1-2% cut in our 2014-15 earnings estimates.

12,500


2015E EV/EBITDA, and our PT offers 6% upside. We see Siloam
as a long-term buy for exposure to Indonesia’s rapidly growing
healthcare market. Any strong pullback would be a good
opportunity to accumulate the leader of Indonesia’s private hospital
market, in our view.

IDR 15,100

SILO IJ

Higher finance costs than expected. Siloam’s interest expense

Maintain IL; buy on any major pullback. Siloam trades at 22.4x

PRICE TARGET

9,000
Sep-13

Siloam Hospital Internasional


Dec-13

Share price (%)
Ordinary shares
Relative to index
Relative to sector
Major shareholder
Free float
Average turnover (USD)

JAKARTA COMPOSITE INDEX (rebased)

Mar-14

Jun-14

-1 mth
-3 mth -12 mth
-1
30
-5
24
LIPPO KARAWACI TBK PT (78.9%)
21%
10,002,785

Source: Company, FactSet

Alvin Witirto
+65 6596 8530
Equity Research
Standard Chartered Bank, Singapore Branch

Important disclosures can be found in the Disclosures Appendix
All rights reserved. Standard Chartered Bank 2014

http://research.standardchartered.com

Equity Research l Siloam Hospital Internasional

2Q14 results highlights
Siloam’s 2Q14 results were in line with consensus, but below our estimates. Its 1H14
net profit met 52% of the consensus estimate, but only 38% of our forecast. We had
initially expected a stronger operating leverage than the street in 2014. We prudently
lower our 2014E EBITDA to IDR 506bn, which is close to management’s guidance of
IDR 508bn.
Figure 1: 2Q14 results review

Year-end Dec

1H14 as %
Our FY14 of FY14E
est.
est.

Cons
2014

% 1H14
cons

43%

3,499

45%

982

44%

955

45%

27.0%

NA

27.3%

NA

2Q13

2Q14

YoY (%)

1H13

1H14

YoY (%)

Sales

617

817

32%

1,201

1,568

31%

3,638

Gross profit

158

218

38%

319

432

35%

% margin

25.6%

26.7%

NA

26.6%

27.5%

NA

EBITDA
% margin

82

98

19%

133

208

56%

517

40%

470

44%

13.3%

12.0%

NA

11.1%

13.3%

NA

14.2%

NA

13.4%

NA

36

33

-9%

43

80

84%

215

37%

207

39%

5.8%

4.0%

NA

3.6%

5.1%

NA

5.9%

NA

5.9%

NA

EBIT
% margin
Net profit

27

19

-30%

22

46

110%

120

38%

89

52%

% margin

4.4%

2.4%

NA

1.8%

2.9%

NA

3.3%

NA

2.5%

NA

EPS (IDR )

27

17

-39%

22

40

82%

104

38%

77

52%

Source: Company, Standard Chartered Research

 Revenue ramp-up is on track: Siloam’s 2Q14 revenue was in line with our and

consensus estimates, at 22% and 23% of full-year 2014 estimates. Its revenue per
inpatient and revenue per outpatient rose up to 26% and up to 50% YoY,
respectively. We believe revenue growth will continue to pick up in 2H14 as patient
volume and revenue per patient ramp up at its younger vintage hospitals.
Management has indicated that 2H14 revenue growth will be stronger than 1H.
Figure 2: Revenue per inpatient
2012

45

2013

Figure 3: Revenue per outpatient

1Q14

2012

2Q14

2013

1Q14

2Q14

2.5

35

2.0
IDR mn per patient

IDR mn per patient

40
30
25
20
15
10

1.5
1.0
0.5

5
0

0.0
Mature

Developing MRCCC

Source: Company, Standard Chartered Research

31 July 2014

RSUS

New - 2012 New - 2013

Mature

Developing MRCCC

RSUS

New - 2012 New - 2013

Source: Company, Standard Chartered Research

2

Equity Research l Siloam Hospital Internasional

 Weaker margins at some mature hospitals: Siloam’s consolidated 2Q14

EBITDA margin of 12.0% was below our expectation of 14.2%. We believe this is
attributable to weaker-than-expected margins at some of its mature hospitals (60%
of revenue in 2013) and at MRCCC (13% of revenue in 2013). EBITDA margins at
two mature hospitals, Kebon Jeruk and Surabaya, were 3-5ppt weaker QoQ at 1315% in 2Q14, compared to 16-20% in 1Q14. EBITDA margin at Cikarang hospital
may have been weaker due to higher rental costs (this hospital has a base rent of
IDR 25bn p.a.), as Siloam said that it paid IDR 16bn in rent in 1H14 (+33% YoY).
Similarly, EBITDA margin at MRCCC was lower than expected at 2.2% in 2Q14
(1H14: 5.5%), compared to our assumption of 13-16% for 2014. We believe this
could be due to a changing case mix, as the volume of general cases could have
risen faster than specialist cancer cases at MRCCC.
 Good margin pick-up at new hospitals: One bright spot in the 2Q14 results is

that the ramp-up of its younger hospitals (established in 2012-13) is proceeding as
planned. We estimate the EBITDA margins at these newer hospitals at 9.5% in
2Q14, largely in line with our forecast of 10% for 2014. We see this as positive, as
it comes amid signs of weakness at Siloam’s more established hospitals.
 EBITDA margin assumption adjustments: We temper our margin expectations

by 20-30bps for 2014-15, and lower our occupancy estimates for several key
hospitals, leading to a 2-7% cut in our 2014-15E earnings. We should note that
there are upside risks to our revised forecast if the margin weakness at some of
Siloam’s mature hospitals proves to be seasonal, due to Ramadan, which came
right after the long school holidays in June.
 Higher finance cost than expected: Siloam’s interest expense in 1H14

amounted to IDR 24bn (66% of our 2014 estimate). We increase our effective
interest rate assumption by 100bps to 12.5% in 2014 and 11.5% in 2015. This
adjustment accounts for the remaining 1-2% cut in our 2014-15E earnings.
 Completion of Siloam’s Purwakarta hospital: Siloam commenced operations at

its Purwakarta hospital in June 2014. Management noted the catchment area for
the hospital includes Indramayu and Subang. This hospital is also registered to
treat patients covered by the National Health Insurance program (JKN). We think
this could help drive a faster revenue ramp-up at this hospital, although margins
may be slightly lower than in Siloam’s non-JKN eligible hospitals.

31 July 2014

3

Equity Research l Siloam Hospital Internasional

Reiterate In-Line
Our DCF-derived price target of IDR 15,100 (from IDR 15,137) translates into 23x
2015E EV/EBITDA and offers a 6% upside potential.

DCF valuation
We value Siloam based on DCF methodology, given its relatively predictable cash
flows from the hospital services business. Our DCF-derived price target assumes a
risk-free rate of 8.5%, cost of debt of 11.5%, equity risk premium of 6%, beta of 1.0x,
target debt to firm value of 0% and implied weighted average cost of capital of 14.5%.
Figure 4: DCF valuation
Stage 1: Explicit 2013-23E

2015E

2016E

2017E

2018E

2019E

2020E

2021E

2022E

2023E

79

192

338

606

950

1,562

2,128

2,949

3,664

4,414

5,422

Change YoY

-14%

144%

76%

80%

57%

64%

36%

39%

24%

20%

23%

EBIT margin

3%

5%

6.5%

8.2%

9.4%

11.4%

12.8%

14.1%

15.1%

15.7%

16.9%

59

144

253

455

712

1,171

1,596

2,212

2,748

3,311

4,067

233

303

446

588

737

854

945

1,022

1,077

1,128

987

EBIT

EBIT (1-tax)
(+) Depreciation and amortisation
(-) Change in working capital

2013 2014E

(67)

(97)

(120)

(165)

(196)

(267)

(226)

(315)

(265)

(287)

(316)

(-) Capital expenditure

(598)

(829)

(1,124)

(1,139)

(1,192)

(1,110)

(1,004)

(1,041)

(1,061)

(1,188)

(1,228)

Unleveraged free cash flow

(373)

(480)

(545)

(261)

62

648

1,310

1,878

2,499

2,963

3,509

0.95

0.83

0.72

0.63

0.55

0.48

0.42

0.37

0.32

0.28

(453)

(450)

(188)

39

356

629

788

916

949

981

2024E

2025E

2026E

2027E

2028E

2029E

2030E

2031E

2032E

2033E

3,808

4,131

4,482

4,863

5,277

5,725

6,212

6,740

7,313

7,934

Discount factor

0.24

0.21

0.19

0.16

0.14

0.12

0.11

0.09

0.08

0.07

Present value of FCFs

930

881

835

792

750

711

674

638

605

573

Discount factor
Present value of FCFs
Stage 2: 2023-33E
Unleveraged free cash flow

Stage 3: Terminal
Terminal value

98,948

Discount factor

0.07

Present value of terminal value

7,152

Equity value

Growth rates assumptions

WACC assumptions

DCF of operations: Stage 1

3,568

Stage 1: 2013-23E

NM

DCF of operations: Stage 2

7,391

Stage 2: 2024-33E

8.5%

Cost of debt

7,152

Stage 3: Terminal

6.0%

Equity risk premium

NPV of the terminal value
Enterprise value (IDR bn)
Net cash (debt)
Minorities
Equity value (IDR bn)
Number of shares outstanding (bn)

18,111
(640)
(33)
17,437
1.156

Fair value per share (IDR)

15,100

Current price (IDR)

14,300

Upside/(downside)

6%

Current 2015E PER

97

Target 2015E PER

102

EBITDA 2015E

783

Target EV/EBITDA 2015E

Risk-free rate

Tax rate
Target debt to firm value
Equity beta
Cost of debt (after tax)

8.5%
11.5%
6.0%
25.0%
0.0%
1.00
8.6%

Cost of equity

14.5%

WACC

14.5%

23

Note: Share price as of 25 July 2014
Source: Bloomberg, Standard Chartered Research estimates

31 July 2014

4

Equity Research l Siloam Hospital Internasional

Relative valuation
Siloam is trading at 22x 2015E EV/EBITDA, at a 23% premium to its regional peers.
We believe the stock deserves to trade at a premium, given the company’s strong
growth pipeline and its EBITDA CAGR of 62% in 2013-16E.
Figure 5: Peer comparison

Name

Ticker

Siloam Intl. Hospitals SILO IJ

Price
target
Rating (LCY)
IL

3M avg.
PER (x)
EV/EBITDA (x)
Div.
value
2Y
Price/
yield ROCE
Price Mkt. cap traded Last
EPS 2Y sales
(%) (%)
(LCY) (USD mn)(USD mn) FYE 2013 2014 2015CAGR PEG 2014 2013 2014 2015 2014 2014

15,100 14,300

1,428

10.49 12/13 300.3 151.9 96.6 76%

1.3

4.2 50.0 34.0 22.4

0.1

7.7
16.9

Regional hospitals
Raffles Medical Group RFMD SP OP

4.47

3.91

1,768

1.21 12/13 34.5 30.0 26.5 14%

1.9

5.8 24.0 22.2 18.7

1.5

KPJ Healthcare

4.14

3.54

1,130

1.49 12/13 35.1 33.9 29.6

9%

3.4

1.4 20.5 18.4 16.6

1.5

7.6

NR

119.50

2,729

5.34 12/13 34.5 33.9 28.5 10%

2.8

5.6 22.6 19.8 17.0

1.6

19.0

Bangkok Dusit Med.

BGH TB NR

16.90

8,205

23.92 12/13 41.7 36.4 30.6 17%

1.8

4.6 26.1 22.4 19.4

1.3

20.6

IHH Healthcare

IHH SP

NR

1.81

11,898

0.34 12/13 59.5 48.8 40.3 22%

1.9

4.9 27.7 21.7 18.8

0.4

6.6

IHH Healthcare

IHH MK

NR

4.71

12,097

6.64 12/13 60.5 49.6 41.0 22%

1.9

5.0 28.1 22.0 19.1

0.4

6.6

44.3 38.8 32.7 15%

2.3

4.5 24.8 21.1 18.3

1.1

12.9

KPJ MK OP

Bumrungrad Hospital BH TB

Note: Share price as of 25 July 2014 for Siloam, as Indonesian market is closed this week, and 30 July 2014 for its regional peers; Bloomberg consensus for NR companies.
Source: Bloomberg, Standard Chartered Research estimates

31 July 2014

5

Equity Research l Siloam Hospital Internasional

Income statement (IDR bn)
Year-end: Dec
Sales
Gross profit
SG&A
Other income
Other expenses
EBIT
Net interest
Associates
Other non-operational
Exceptional items
Pre-tax profit
Taxation
Minority interests
Exceptional items after tax
Net profit

Cash flow statement (IDR bn)
2012
1,788
445
(368)
15
0
91
(5)
0
(9)
0
77
(25)
(1)
0
50

2013
2,504
659
(583)
3
0
79
(0)
0
(7)
0
72
(22)
(0)
0
50

2014E
3,548
958
(766)
9
0
192
(27)
0
(11)
0
155
(43)
(3)
0
109

2015E
5,186
1,426
(1,089)
13
0
338
(79)
0
(16)
0
243
(67)
(5)
0
171

2016E
7,434
2,081
(1,475)
19
0
606
(145)
0
(22)
0
439
(121)
(9)
0
309

50
212

50
281

109
495

171
783

309
1,194

50
50
0
1,000

48
48
5
1,047

94
94
9
1,156

148
148
22
1,156

267
267
53
1,156

Year-end: Dec
Cash
Short-term investments
Accounts receivable
Inventory
Other current assets
Total current assets

2012
169
0
187
75
26
457

2013
515
0
271
95
26
907

2014E
293
0
389
142
52
876

2015E
46
0
568
206
74
894

2016E
36
0
815
293
105
1,249

PP&E
Intangible assets
Associates and JVs
Other long-term assets
Total long-term assets

865
61
0
203
1,129

1,402
188
0
103
1,693

1,933
184
0
103
2,220

2,616
179
0
103
2,898

3,171
175
0
103
3,449

Total assets

1,586

2,601

3,095

3,792

4,698

16
156
96
268

17
164
115
296

17
230
142
389

17
334
185
536

17
476
242
735

Long-term debt
Convertible bonds
Deferred tax
Other long-term liabilities
Total long-term liabilities

55
0
0
1,019
1,074

43
0
0
623
666

543
0
0
423
966

1,043
0
0
323
1,366

1,543
0
0
273
1,816

Total liabilities

1,342

962

1,355

1,901

2,551

Shareholders’ funds
Minority interests

245
0

1,639
0

1,740
0

1,891
0

2,147
0

Total equity

245

1,639

1,740

1,891

2,147

Total liabilities and equity

1,586

2,601

3,095

3,792

4,698

Net debt (cash)
Year-end shares (mn)

(98)
1,000

(456)
1,047

267
1,156

1,014
1,156

1,523
1,156

Net profit adj.
EBITDA
EPS (IDR)
EPS adj. (IDR)
DPS (IDR)
Avg fully diluted shares (mn)

Balance sheet (IDR bn)

Short-term debt
Accounts payable
Other current liabilities
Total current liabilities

Year-end: Dec
EBIT
Depreciation & amortisation
Net interest
Tax paid
Changes in working capital
Others
Cash flow from operations

2012
91
120
(14)
(33)
(45)
84
203

2013
79
202
(7)
(27)
(67)
10
189

2014E
192
303
(27)
(43)
(97)
(11)
317

2015E
338
446
(79)
(67)
(120)
(16)
502

2016E
606
588
(145)
(121)
(165)
(22)
741

Capex
Acquisitions & Investments
Disposals
Others
Cash flow from investing

(523)
(53)
0
61
(515)

(598)
(163)
1
0
(761)

(829)
0
0
0
(829)

(1,124)
0
0
0
(1,124)

(1,139)
0
0
0
(1,139)

Dividends
Issue of shares
Change in debt
Other financing cash flow
Cash flow from financing

0
0
320
0
320

0
0
(423)
1,326
904

(11)
0
500
(200)
289

(26)
0
500
(100)
374

(62)
0
500
(50)
388

9
0
(320)

333
0
(409)

(222)
0
(512)

(248)
0
(622)

(9)
0
(397)

2012

2013

2014E

2015E

2016E

24.9
11.8
5.1
2.8
32.5
42.0
15.4
15.4
15.4
-

26.3
11.2
3.1
2.0
30.1
40.0
-1.2
-5.6
-5.6
nm

27.0
13.9
5.4
3.1
27.5
41.7
118.3
97.7
97.7
97.7

27.5
15.1
6.5
3.3
27.5
46.2
57.2
57.2
57.2
135.8

28.0
16.1
8.2
4.2
27.5
43.3
80.8
80.8
80.8
141.0

23.8
8.2
1.3
2.2
0.2
16.2
31.8
36.6

5.3
4.3
1.2
2.4
0.3
16.8
33.4
31.6

6.4
7.7
1.2
1.7
0.4
16.7
33.9
27.8

9.4
11.3
1.5
1.5
0.4
16.9
33.7
27.4

15.3
16.8
1.8
1.2
0.5
17.0
34.0
27.6

-40.0
5.4
10.7
0.4
1.7

-27.8
2.6
6.5
0.2
3.1

15.3
20.7
5.0
0.6
2.2

53.6
32.5
3.6
1.0
1.7

70.9
39.4
4.0
1.1
1.7

-

4.1
36.1
129.0
209.2
209.2
6.1
0.0

4.7
34.0
87.5
151.9
151.9
9.5
0.1

3.4
22.4
52.0
96.6
96.6
8.7
0.2

2.4
15.1
29.8
53.5
53.5
7.7
0.4

Change in cash
Exchange rate effect
Free cash flow

Financial ratios and other
Year-end: Dec
Operating ratios
Gross margin (%)
EBITDA margin (%)
EBIT margin (%)
Net margin adj. (%)
Effective tax rate (%)
Sales growth (%)
Net income growth (%)
EPS growth (%)
EPS growth adj. (%)
DPS growth (%)
Efficiency ratios
ROE (%)
ROCE (%)
Asset turnover (x)
Op. cash/EBIT (x)
Depreciation/capex (x)
Inventory days
Accounts receivable days
Accounts payable days
Leverage ratios
Net gearing (%)
Debt/capital (%)
Interest cover (x)
Debt/EBITDA (x)
Current ratio (x)
Valuation
EV/sales (x)
EV/EBITDA (x)
EV/EBIT (x)
PER (x)
PER adj. (x)
PBR (x)
Dividend yield (%)

Source: Company, Standard Chartered Research estimates

31 July 2014

6

Equity Research l Siloam Hospital Internasional

Disclosures appendix
The information and opinions in this report were prepared by Standard Chartered Bank (Hong Kong) Limited, Standard Chartered Bank Singapore Branch, Standard
Chartered Securities (India) Limited, Standard Chartered Securities Korea Limited and/or one or more of its affiliates (together with its group of companies, ”SCB”)
and the research analyst(s) named in this report. THIS RESEARCH HAS NOT BEEN PRODUCED IN THE UNITED STATES.
Analyst Certification Disclosure: The research analyst or analysts responsible for the content of this research report certify that: (1) the views expressed and
attributed to the research analyst or analysts in the research report accurately reflect their personal opinion(s) about the subject securities and issuers and/or other
subject matter as appropriate; and (2) no part of his or her compensation was, is or will be directly or indirectly related to the specific recommendations or views
contained in this research report. On a general basis, the efficacy of recommendations is a factor in the performance appraisals of analysts.
Where “disclosure date” appears below, this means the day prior to the report date. All share prices quoted are the closing price for the business day prior to the
date of the report, unless otherwise stated.

Recommendation and price target history for Siloam Hospital Internasional

IDR
15,137

2

1

13,990
12,842

11,695
10,547
9,400
Oct-13
Date
1 8 Apr 14

Jan-14

Recommendation
OUTPERFORM

Price target
13,982

Date
2 25 Jun 14

Apr-14
Recommendation
IN-LINE

Price target

Jul-14
Date

Recommendation

Price target

15,137

Source: FactSet prices, SCB recommendations and price targets

Recommendation Distribution and Investment Banking Relationships
% of covered companies
currently assigned this rating

% of companies assigned this rating with which SCB has provided
investment banking services over the past 12 months

OUTPERFORM

55.8%

10.4%

IN-LINE

33.0%

10.1%

UNDERPERFORM
As of 30 June 2014

11.2%

8.1%

Research Recommendation
Terminology
OUTPERFORM (OP)
IN-LINE (IL)
UNDERPERFORM (UP)

Definitions
The total return on the security is expected to outperform the relevant market index by 5% or more over the next 12 months
The total return on the security is not expected to outperform or underperform the relevant market index by 5% or more over the next
12 months
The total return on the security is expected to underperform the relevant market index by 5% or more over the next 12 months

SCB uses an investment horizon of 12 months for its price targets.
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scer@sc.com.
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31 July 2014

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Equity Research l Siloam Hospital Internasional

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