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SAINT LOUIS UNIVERSITY SAINT LOUIS UNIVERSITY

DEPARTMENT OF PHARMACY DEPARTMENT OF PHARMACY


PHARMACY INTERNSHIP PHARMACY INTERNSHIP
() Community ( ) Hospital ( ) Manufacturing () Community ( ) Hospital ( ) Manufacturing
Name of Intern: AQUINO, CZARINAH MAE L. Name of Intern: AQUINO, CZARINAH MAE L.
Name of Internship Site: The Generics Pharmacy Name of Internship Site: The Generics Pharmacy
For the Month of : March Year: 2013 For the Month of : April Year: 2013
A.M. P.M. Number of A.M. P.M. Number of
Arrival Departure Arrival Depature Hours Minutes Arrival Departure Arrival Departure Hours Minute
1 Departure 1 8:00 12:00 1:00 5:00 8 s
2 2 8:00 12:00 1:00 5:00 8
3 3 8:00 12:00 1:00 5:00 8
4 4 8:00 12:00 1:00 5:00 8
5 5 8:00 12:00 1:00 5:00 8
6 6
7 7
8 8 8:00 12:00 1:00 5:00 8
9 9 8:00 12:00 1:00 5:00 8
10 10 8:00 12:00 1:00 5:00 8
11 11 8:00 12:00 1:00 5:00 8
12 12 8:00 12:00 1:00 5:00 8
13 13
14 14
15 15 8:00 12:00 1:00 5:00 8
16 16 8:00 12:00 1:00 5:00 8
17 17 8:00 12:00 1:00 5:00 8
18 18 8:00 12:00 1:00 5:00 8
19 19 8:00 12:00 1:00 5:00 8
20 20
21 21
22 22 8:00 12:00 1:00 5:00 8
23 23 8:00 12:00 1:00 5:00 8
24 24 8:00 12:00 1:00 5:00 8
25 8:00 12:00 1:00 5:00 8 25 8:00 12:00 1:00 5:00 8
26 8:00 12:00 1:00 5:00 8 26 8:00 12:00 1:00 5:00 8
27 8:00 12:00 1:00 5:00 8 27
28 8:00 12:00 1:00 5:00 8 28
29 8:00 12:00 1:00 5:00 8 29
30 30
31 31
TOTAL: 40 hours TOTAL:160 hours

_________________________________ _________________________________
Intern's Signature Intern's Signature
Lily C. Canuto, RPh Lily C. Canuto, RPh
Name & Signature of Pharmacist-in-Charge Name & Signature of Pharmacist-in-Charge
Prof. Tax No. (PTR) : 1337424 Noted by: Prof. Tax No. (PTR) : 1337424 Noted by:
Date Issued: 01/07/2013 Date Issued: 01/07/2013
Reg. No. (License): 0059736 Reg. No. (License): 0059736
Date Issued: 11/02/2011 Maam Adeltrudes B. Caburian, RPh, PhD Pharm Date Issued: 11/02/2011 Maam Adeltrudes B. Caburian, RPh, PhD Pharm
Date of Expiry : 03/09/2014 Internship Coordinator's Name & Signature Date of Expiry : 03/09/2014 Internship Coordinator's Name & Signature

DR. GAUDELIA A. REYES DR. GAUDELIA A. REYES


Dean's Name & Signature Vernice O. Paculan Dean's Name & Signature
Vernice O. Paculan
Name & Signature of the Manager/Director Name & Signature of the Manager/Director

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