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INDUSTRIAL TRAINING/CLINICAL POSTING/INDUSTRIAL ENGAGEMENT VISIT REPORT

FORM
1. Programme : ……………………………………………………………………………………………………………
2. Semester : ……………………………………………………………………………………………………………
3. Date of Visit : ………………………………………………………………………………………………….
4. Representative from the college : ….……………………………………………………………………………
5. Representative from the organization : ….………………………………………………………………….

List of Students on Attachment, if the visit is for Industrial Training/Clinical Posting visit:

No. Name Student ID

Purpose of the Visit:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

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INDUSTRIAL TRAINING/CLINICAL POSTING/INDUSTRIAL ENGAGEMENT VISIT REPORT
FORM
Feedback from the Supervisor/Local Preceptor/Representative:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Feedback from Visiting Lecturer(s):

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Feedback from Student(s), if the visit is for Industrial Training/Clinical Posting visit:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

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INDUSTRIAL TRAINING/CLINICAL POSTING/INDUSTRIAL ENGAGEMENT VISIT REPORT
FORM
Recommended Action(s):

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Prepared by: Received by: Reviewed by:

Lecturer Programme Leader Head of Academic

Name: Name: Name:

Date: Date: Date:

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