Meniuni sau observaii ale medicului de

gard: Studentul a respectat programul de gard;

a manifestat interes; a efectuat activitile
corespunztoarea nivelului de pregtire; s-a
integrat n echipa de gard etc.
GARDA I_____________________________

UNIVERSITATEA DE MEDICIN I
FARMACIE GR.T.POPA IAI
FACULTATEA DE MEDICIN

ACTIVITATE PRACTIC
INDIVIDUAL - GRZI
GARDA II_____________________________
______________________________________
GARDA III ___________________________

Numele i prenumele studentei / studentului:

_______________________________________
Anul de studiu:____, Seria:_____, Grupa____,

GARDA IV ___________________________
______________________________________

Data:________,
Viza Decanat,

GRZI EFECTUATE sem.I

Clinica: __________________________,

GRZI EFECTUATE sem.II

Clinica: __________________________,

Data:____________________________,

Data:____________________________,

Medic de gard:____________________,

Medic de gard:____________________,

Nota acordat:_____________________,

Nota acordat:_____________________,

Semntura:________________________,

Semntura:________________________,

Clinica: __________________________,

Clinica: __________________________,

Data:____________________________,

Data:____________________________,

Medic de gard:____________________,

Medic de gard:____________________,

Nota acordat:_____________________,

Nota acordat:_____________________,

Semntura:________________________,

Semntura:________________________,