ABCDEFGHIJKLMNOPQRSTUVWXYZ
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Family Care Health Centers
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Student Time Record
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Name:
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Month:JULY 2023
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DATE (Enter Date Below)HOURS (Enter Hours Worked below)
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7/1/2023
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7/2/2023
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7/3/2023
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7/4/2023
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7/5/2023
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7/6/2023
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7/7/2023
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7/8/2023
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7/9/2023
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7/10/2023
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7/11/2023
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7/12/2023
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7/13/2023
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7/14/2023
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7/15/2023
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7/16/2023
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7/17/2023
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7/18/2023
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7/19/2023
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7/20/2023
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7/21/2023
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7/22/2023
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7/23/2023
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7/24/2023
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7/25/2023
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7/26/2023
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7/27/2023
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7/28/2023
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7/29/2023
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7/30/2023
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7/31/2023
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Total Hours Worked
0
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We, the undersigned, do hereby verify that it is a true and accurate statement of hours worked.
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Student's Signature: (Type)
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Date:
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Preceptor's Signature: (Type)
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Date:
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Revised: 2023
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