RECTOR

Of Crimea State Medical University

Named after S.I. Georgievsky
Professor Babanin A.A.

95006 Lenin blvd. 517

Simdferopol, Crimea, Ukraine

Administration of Hospital country City

hospital names
agrees to accept the student of the 5- th year course of the Medical International Faculty of Crimea

State Medical University (CSMU) by the name of

Student names
for the medical elective posting in the polyclinic in Therapy, Surgery, Gynecology and

Pediatric officeses to complete the medical training of doctor without a degree for a period of 4

weeks under direction of the University (CSMU) (4 weeks -1 44 hours) or 2 officeses ( 6 weeks).

There are very own structure officeses of Therapy,. Surgery, Gynecology and Pediatric in
our hospital.

After the medical elective posting of

student names
we will forward the student a valid document which states that the student has accomplishted

the medical training in our hospital for the above clinical subjects.

Financial interconting and claims about practical work of

Student names
between the medical University and the Hospital are completely excluded.

On behalf of the Hospital , I hereby would like to thank you in advance and express the hope
L.

for future cooperation.

Director of Hospital,
Name of Hospital
Stamp
Name:
Signature:

- -

Tel:
Fax: