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UNIVERSITATEA DE MEDICIN I FARMACIE

,,CAROL DAVILA BUCURETI


FACULTATEA DE MEDICINA

CERERE,
IN ATENIA: D-lui Decan, Prof. Univ. Dr. Florin Ctlin Crstoiu

Subsemnatul__________________________________________________student() la
Universitatea de Medicina i Farmacie ,,Carol Davila Bucureti, Facultatea de Medicin, anul____,
seria______ ,grupa_______, v rog sa-mi aprobai efectuarea lucrrii de licen cu titlul:

_________________________________________________________________________________

_________________________________________________________________________________

n cadrul Disciplinei de_______________________________________________________________

sub coordonarea_____________________________________________________________, si

ndrumarea______________________________________________________________________.

V multumesc pentru increderea acordata!

Coordonator

___________________________

(nume i prenume)

Cu respect

_______________________________

(semntura) Indrumtor

_________________________

(semntur i parafa)

Data Spitalul/Clinica

_______________ ________________________

(stampila institutiei)