Pamantasan ng Lungsod ng Pasig

Alcalde Jose Street, Kapasigan, Pasig City

COLLEGE OF NURSING

MAKE-UP DUTY SLIP

Name: _____________________________________________________
Year and section: ________________________
Agency: ___________________________________________________
Date of Make-up Duty:
________________________________________
Number of hours scheduled: ________________
Number of hours completed: ________________

Supervised by: ______________________________________________

Date: ____________________________________
Remarks: _________________________________________________
__________________________________________________________
___________________________________________________________
_________________________________________________________

Record of Related Learning Experience in Agencies

Agency Number of Hours

___________________________ ___________________________
___________________________ ___________________________
___________________________ ___________________________
___________________________ ___________________________
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