~ l i j POii'

ALAIN UNIVERSITY

Al Ain University
College of Pharmacy
Introductory Pharmacy Practice Experience 2 (0203390)
Attendance Record Completed by the Preceptor
Preceptor Detaib ..
,.-.'X'j~f. ...cr.~fQ~.~-- ................................... Pharmacy Name.......
• ..,A,..
Preceptor Name .. . Med~1C,/:'\.~
" ••••••1:t, r->.m.,,
Preceptor Qualification: .. p. ha.c roa..c.~s.t...•l.'.-:-.C.~C..:J e .............. Phone/Mobile Number: ...O.S:?:-~1S.Q.?.$. ':l$."
Preceptor Position in the Pharmacy: ·f-~Q.CM~C.~:t.. Jo.-:"h"-C"!Jf_..... E-mail address:.r.':'.e.G\.~C~C\A.:~.\S. 1:rn'i..~ ~:c.'n°' • c:te

Student's Details:
Student's Name: .... M~.(V.\"te:\ l\ f\ ~- ...(ih~r.e.C;~ ................
Students I.D.: .... .W. ~Ll q_q_ ~ ...................................... .

Date Day AM PM Total Comments and Signature

In Out In Out Hrs
s ~,
Su /
\3 /5/ ~01y M q G,rt" c_5 9. /
.
Pl'"\

\"t /S/20l.4 T q~"" s Qf'W"\ i1, I

\ ~ J 5 I '.l 02. '4 w q ~"" 5 () rt' s \
16 / ~ / '2.0 ':l.. Y Th q • (\'\ s r,~ g "-...
l i I$/ !,lO:J."I Fri q Qr" 5 Or" Y> ~
s ~
Su )
~o 15 I -i.02'-t M G\ Oll"" ~ Pr' f> /
'l \ / 5 I 'l 02.'-1 T q --f"' c; t> ~ s /
2~ ,~ / lO'l. 'i w '?> f ("C' HPM s (
Th g
2~/$'/;).02.'i
2 'i / S I 'l-0 .2.. '-f Fri
s
~ "'""
~(>~ I\ f~
\\ p rt' 8 \
Su
- -
\
~,IS/2.cn_Y M q (ll"t', ~ () ('I\ ~
2Sl/ >" / 202. y T q .<" g
w
"',r..
.
C>rc-.
'J.Ct/5'° /l.Oj.~ " ~M ~
"""
g I
30I ~ I ').o? '4 Th ~ g A I /)
q """ r""
~\It; I 2..0.l-"f Fri 'f ,:J.I"' tt; PM g 4ft, u/lk I,vc f' /11 )

Total Hrs \2-0 V[ \.. ) • r/ :;t\,- -'--,...,

\._
f I\.,/ I I - - \ ~

H~·a~ A0M1
This form should be completed and signed by the preceptor at the training site. The student will collect the
form at the end of the training period and should include a copy of it in the training report, l-Vhile the
original is handed to the college training supervisor.