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
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(nume i prenume)
Cu respect
_______________________________
(semntura)
Indrumtor
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(semntur i parafa)

Data
Spitalul/Clinica
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(stampila institutiei)