Joseph Tein Dec 14, 2010:

The additional context makes things clearer; however I still couldn't figure it out ... but it looks as though Kate has given you the answer. It's always easier to figure these things out if you actually live in the country.

garrett higgins (asker) Dec 14, 2010:

at the very bottom of the page, on the LHS, after the signature (where the "Attachments" are usually specified). Signed by the President of a Medical Foundation.

Joseph Tein Dec 14, 2010:

Context please This would be clearer if we knew: HOW FAR at the bottom? What comes before this? Who wrote the letter?

This is probably a plural "something" ... they often indicate plural in an abbreviation by doubling up on the letters (like AAII = arti inferiori) ... but more context would really help take some of the guesswork out of this.