You are on page 1of 1

THE IRAQI BOARD FOR MEDICAL SPECIALIZATIONS ‫المجلس العراقي لالختصاصات الطبية‬

SCIENTIFIC COUNCIL OF GENERAL SURGERY ‫المجلس العلمي للجراحة العامة‬


(A)
NAME OF STUDENT : GRADE /
SPECIALITY : YEAR /
SUPERVISER: CENTER /
TRAINING PERIOD : FROM / / to : / /
OPERATION SUPERVISORS
DATE OBS ASS SUR SIGNATURE
PATIENTS AGE OPERATION
NAME

SUPERVISORS TRAINING CENTER SUPERVISIOR CHAIRMAN OF SCIENTIFIC COUNCIL

You might also like