Karaganda Medical University
«Medicine and Ecology» journal
Monthly newspaper «Medic»
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Application form

   F KMU NCJSC 16-06/4

Title side

  To the library director of

  KMU

                                                                                                                   ____________

Request (from department)

To ensure the educational process I kindly ask you to purchase the book in the holding of library:

Аuthor and title

Language

The year of publishing

Source

Customer

Discipline

Specialty

Basics/additional

Quantity

Name of department________________________________________________________

Head of department__________________________________

Date ___________________

Reverse side

                                                                                                               

1.  The same publication available in the library:

________________________________________________________exemplar

________________________________________________________exemplar

2.  Provided exemplar according to TTAP ____________________________

3.   Request № in OWD

4.  Satisfaction:  ____________________________________________________________

Date ___________                                                            Selector signature______________