College of pharmacy College of pharmacy
Internship Daily Time Record Internship Daily Time Record
________________________________________ ________________________________________
Name of Intern: Name of Intern:
Name of Pharmaceutical establishment: Name of Pharmaceutical establishment:
___________________________________________________
Address :
Address :
For the Month of:
For the Month of:
============================================= ==============================================
DATE A.M. P.M.
DATE A.M. P.M. Arrival Departure Arrival Departure Hours Minutes
Arrival Departure Arrival Departure Hours Minutes
1
1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
TOTAL= hrs. TOTAL= hrs.
---------------------------------------------------------------- ---------------------------------------------------------------
Hospital Pharmacy Hospital Pharmacy
Community Pharmacy Community Pharmacy
Manufacturing Pharmacy ____________________________ Manufacturing Pharmacy ____ ____________________
Intern’s Signature above printed name Intern’s Signature above printed name
Prof. Tax No.: _______________ Prof. Tax No.: ____________
Date Issued : _____________ D ate Issued: ____________
Reg. No. : ____________ Reg. No. ____________.
Pharmacist ‘s signature above printed name
Pharmacist ‘s signature above printed name
Certified: Noted:
Certified: Noted: Socorro B.Gutierrez.MSPh
President of the Firm Dean
Socorro B.Gutierrez.MSPh ------------------------------------------------------------------------------
President of the Firm Dean
----------------------------------------------------------------