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:

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n cadrul Disciplinei de_______________________________________________________________

sub coordonarea_____________________________________________________________, si

ndrumarea______________________________________________________________________.

V multumesc pentru increderea acordata!

Coordonator

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(nume i prenume)

Cu respect

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(semntura) Indrumtor

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(semntur i parafa)

Data Spitalul/Clinica

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(stampila institutiei)