Escolar Documentos
Profissional Documentos
Cultura Documentos
I. Date personale
Numele i prenumele : ______________________________ ; anul naterii __________ ;
localitatea __________________ ; judeul ____________________ ;
A absolvit clasele anterioare la : _________________________________________________
II. Date asupra familiei
1. Ocupaia i locul de munc al prinilor
a) Tata
__________________________________________________________________
b) Mama
__________________________________________________________________
2. Atmosfera i climatul educativ n familie ____________________________________
3. Starea de sntate a familiei _____________________________________________
III. Starea de sntate a elevului
a) Dezvoltarea fizic
Deficitar ____________________________________________________________
Bun _______________________________________________________________
b) Antecedente boli
Acute _____________ ; cronice ______________ ; traumatisme _______________
IV. Performan colar
_____________________________________________________________________
V. Activiti n afara clasei i a colii
_____________________________________________________________________