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ԕɚɛɵɥɞɚɭ ɬɭɪɚɥɵ ɤɭԥɥiɤ _______________________________ ԕɚɥɚɫɵ (ɚɭɵɥɵ, ɤɟɧɬi, ԧɥɤɟɫi, ɨɛɥɵɫɵ) _______________________________________ ԕɚɥɚɫɵ (ɤɟɧɬi, ɚɭɵɥɵ, ɨɛɥɵɫɵ) __________________________________________________________________ (ɤԛɧi, ɚɣɵ, ɠɵɥɵ) Ɇɟɧ,___________________________________________,___________________ (ɦɟɦɥɟɤɟɬɬiɤ ɧɨɬɚɪɢɚɬ ɤɟԙɫɟɫiɧiԙ ɚɬɚɭɵ ɧɟɦɟɫɟ ɠɟɤɟɲɟ ɧɨɬɚɪɢɭɫ __________________________________________________________________ ɥɢɰɟɧɡɢɹɫɵɧɵԙ ɧԧɦiɪi ɦɟɧ ɤԛɧi) __________________________________________________________________ ɧɨɬɚɪɢɭɫɵ __________________________________________________________________ (Ɍ.Ⱥ.Ԥ.) ___________________ ɬԝɪɚɬɵɧ ɚɡ. ___________________________________ (ɨɧɵԙ ɬԝɪɚɬɵɧ ɠɟɪi) (Ɍ.Ⱥ.Ԥ.,ɬɭԑɚɧ ɠɵɥɵ, ɬɭԑɚɧ ɠɟɪɿ) 20_____ ɠɵɥɞɵԙ "______"____________ _______ _______________________ (ɦɟɤɟɧ ɠɚɣɵ) ɦɟɦɥɟɤɟɬɬiɤ ɧɨɬɚɪɢɚɬ ɤɟԙɫɟɫiɧɟ (ɧɟɦɟɫɟ ɠɟɤɟɲɟ ɧɨɬɚɪɢɭɫԕɚ)__________ _________________ ɦɟɪɡiɦɝɟ ԕɨɫɚ ɛɟɪiɥiɩ ɨɬɵɪԑɚɧ ɬiɡiɦɞɟɦɟɝɟ ɫԥɣɤɟɫ (ɦɟɪɡiɦi ɫԧɡɛɟɧ ɤԧɪɫɟɬiɥɟɞi) ԕԝɠɚɬɬɚɪɞɵ ɦɚԑɚɧ ɫɚԕɬɚɭԑɚ ɬɚɩɫɵɪԑɚɧɵɧ ɤɭԥɥɚɧɞɵɪɚɦɵɧ. Ԕԝɠɚɬɬɚɪɞɵ ɫɚԕɬɚɭԑɚ ɬɚɩɫɵɪԑɚɧ ɚɞɚɦɧɵԙ ɠɟɤɟ ɛɚɫɵ ɚɧɵԕɬɚɥɞɵ, ԥɪɟɤɟɬ ԕɚɛɿɥɟɬɬɿɥɿɝɿ ɬɟɤɫɟɪɿɥɞɿ. ʋ _______ɬiɡiɥiɦɞɟ ɬiɪɤɟɥɞi Ɇɟɦɥɟɤɟɬɬiɤ ɛɚɠ ԧɧɞiɪiɥɞi ɧɟɦɟɫɟ ɠɟɤɟɲɟ ɧɨɬɚɪɢɭɫԕɚ ɬԧɥɟɧɝɟɧ ɫɨɦɚ ________ 187 ɦԧɪ ɇɨɬɚɪɢɭɫ ____________ Ԧɬiɧiɲ ɛɟɪɭ ɬɭɪɚɥɵ ɤɭԥɥiɤ _______________________________________ ԕɚɥɚɫɵ (ɤɟɧɬi, ɚɭɵɥɵ, ɨɛɥɵɫɵ) __________________________________________________________________ (ɤԛɧi, ɚɣɵ, ɠɵɥɵ) Ɇɟɧ,___________________________________________,___________________ (ɦɟɦɥɟɤɟɬɬiɤ ɧɨɬɚɪɢɚɬ ɤɟԙɫɟɫiɧiԙ ɚɬɚɭɵ ɧɟɦɟɫɟ ɠɟɤɟɲɟ ɧɨɬɚɪɢɭɫ __________________________________________________________________ ɥɢɰɟɧɡɢɹɫɵɧɵԙ ɧԧɦiɪi ɦɟɧ ɤԛɧi) __________________________________________________________________ ɧɨɬɚɪɢɭɫɵ __________________________________________________________________ (Ɍ.Ⱥ.Ԥ.) "ɇɨɬɚɪɢɚɬ ɬɭɪɚɥɵ" ԔɊ Ɂɚԙɧɵԙ 84-ɛɚɛɵɧɵԙ ɧɟɝiɡiɧɞɟ ɦɟɧ ɚɪԕɵɥɵ________ ɠɵɥɞɵԙ "____"______________________________________________________ (Ɍ.Ⱥ.Ԥ.ɬɭԑɚɧ ɠɵɥɵ, ɬɭԑɚɧ ɠɟɪɿ ɧɟɦɟɫɟ ԧɬɿɧɿɲ ɛɟɪɝɟɧ _____________ ɛɟɪɝɟɧiɧ ɤɭԥɥɚɧɞɵɪɚɦɵɧ. ԝɣɵɦɧɵԙ ɚɬɚɭɵ) Ԧɬiɧiɲ ɦɚɡɦԝɧɵ ɦɵɧɚɞɚɣ___________________________________________________________ __________________________________________________________________ (ԧɬiɧiɲɬiԙ ԕɵɫԕɚɲɚ ɦɚɡɦԝɧɵ ɤԧɪɫɟɬiɥɟɞi) Ԧɬiɧiɲ ɛɟɪɝɟɧ ɚɡɚɦɚɬɬɵԙ (ԧɤiɥɞiԙ) ɠɟɤɟ ɛɚɫɵ ɚɧɵԕɬɚɥɞɵ, ԥɪɟɤɟɬ ԕɚɛɿɥɟɬɬɿɥɿɝɿ ɬɟɤɫɟɪɿɥɞɿ. ʋ _______ɬiɡiɥiɦɞɟ ɬiɪɤɟɥɞi Ɇɟɦɥɟɤɟɬɬiɤ ɛɚɠ ԧɧɞiɪiɥɞi ɧɟɦɟɫɟ ɠɟɤɟɲɟ ɧɨɬɚɪɢɭɫԕɚ ɬԧɥɟɧɝɟɧ ɫɨɦɚ ________ ɦԧɪ ɇɨɬɚɪɢɭɫ ________ (ԕɨɥɵ) |