If you don't have access to a CNC, you can print this part on a 200mm x 200mm bed and use it as a template for manual routing.
Print it out with multiple perimeters and at least 25% infill for maximum rigidity.
Attach it to your MDF with a couple of clamps and drill the holes using a drill press. Flip the template and use bolts in the overlapping holes (e.g. the four around the rectangular middle opening) as registration markers. Drill the remaining holes.
Use a flush cutter (up to 6mm) to manually cut out one side of the part. Then flip the template again and cut out the other side.
Use a flush cutter with a bearing so the rotating shaft of your cutter does not touch the printed part (it would melt).