Uttarpradesh University of Medical Sciences MBBS Internship Format

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Uttar Pradesh University of Medical Sciences, Saifai, Etawah

Department wise MBBS Internship Completion Certificate


Name of Intern: .................................................................................................. Mobile No.:.................................................................... Provisional Reg. No. .............................
ACADEMIC DETAIL
Sl.No. Examination Month & Year Attempt
1 First Professional M.B.B.S. Exam

2 Second Professional M.B.B.S. Exam

3 Final Part-1 Professional M.B.B.S. Exam

4 Final Part-2 Professional M.B.B.S. Exam

MBBS Intrnship Period: From ............../............../................. to ............../............../.................


Dates of Internship Completion Leave Record Signature & Stamp of HOD
Actual
Sl Department (please mention
Duration From To
if leave availed)
........../........../........ ........../........../........
Community 02
1
Medicine Months

General Medicine ........../........../........ ........../........../........


02
2 including
Months
Psychiatry

General Surgery
........../........../........ ........../........../........
02
3 including
Months
Anaesthesia

Obst. & Gynae ........../........../........ ........../........../........


02
4 including Family
Months
Welfare Planning
........../........../........ ........../........../........
01
5 Paediatrics
Month

........../........../........ ........../........../........
Orthopaedics 01
6
including PMR Month

........../........../........ ........../........../........
15
7 Ophthalmology
Days

........../........../........ ........../........../........
15
8 E.N.T.
Days

........../........../........ ........../........../........
15
9 Casualty
Days

Electives
15
........../........../........ ........../........../........
10
Days
................................
If Extension (please mention):
Extension Period Completion Dates Signature & Stamp of HOD
Sl Department Days
From To

........../........../........ ........../........../........
........../........../........ ........../........../........
........../........../........ ........../........../........
NOTE:- If internship hospital is other than UPUMS, then please enclosed the internship completion certificate issued by concerned hospital/institution.

Signature of Intern with date


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