Avizat

Director Departament
De acord,
Prof. coordonator

Domnule Director,

Subsemnatul (a) ___________________________________________ student n anul V

de studiu (2012-2013) Seria III, Grupa 18, domeniul Medicina Generala, v rog s aprobai
ntocmirea lucrrii de licenta cu tema:
____________________________________________________________________________
________________________________________________________________________
____________________________________________________________________________s
ub coordonarea tiinific a _____________________________________________________.

Data,

Semntura student,

Domnului Director al Departamentului de Psihologie