Supervisor'S Data - Cpsp Form B
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1
2COLLEGE OF
R
esearch
FORM "8"
PHYSICIANS
and
T
raining
AND SURGEONS
Monitoring
PAKISTAN
C
el
l
SUPERVISOR'S DATA
PERSONAL DATA
FULL NAME
PASTE
FATHER 'S
I HUSBAND'S NAME
COLOUR PHOTO
DATE OF
BIRTH
DESIGNATION
INSTITUTION
MAILING ADDRESS
(RESIDENTIAL ONLY)
,/
PHONE
(RES)
HOSPITAL
CLINIC
MOBILE
FAX
EMAIL
QUALIFICATIONS
'Qualifications
awarded honorarily should not be mentioned
_ .
I
QUALIFICATIONS
'
YEAR
INSTITUTION
(RESIDENTIAL
ONLY)
I
EDUCATIONAL WORKSHOP ATTENDED
(IF
YES.
GIVE DATES) (CROSS OUTTHOSE NOT ATIENDED)
TITLE OF WORKSHOP
YES
NO
YEAR
PLACE
1. EDUCATION
PLANNING
&
EVALUATION
2. ASSESSMENT OF COMPETENCE
3. SUPERVISORY SKILLS
4. RESEARCH METHODOLOGY
5. OTHERS
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