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DATOS PERSONALES
DNI o pasaporte: 
81
CUIL: 
77
INFORMACIÓN DE CONTACTO
Teléfono celular: 
71
País: 
Congo, The Democratic Republic of the
INFORMACIÓN PROFESIONAL Y DE TRABAJO
Profesión: 
15
Años de experiencia profesional: 
35
Nivel educativo: 
Técnico
¿Usted trabaja en una institución dependiente del Ministerio de Salud de la Nación?: 
No
Usted es:: 
Jefe de residentes
Institución dependiente del Ministerio de Salud de la Nación: 
Otro
Categoría: 
35
Nivel de grado: 
14
Situación de revista: 
52
Cargo Actual: 
61
Responsabilidades del cargo en relación a los objetivos del curso: 
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Email primario: 
Estado/Provincia: 
13
OTROS DATOS
¿Ha realizado algún curso con modalidad virtual?: 
¿Ha participado de otros cursos del CVSP?: 
Especifique los cursos y el año: 
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¿Cómo se enteró del curso?: 
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¿Cuáles son sus expectativas para este curso?: 
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Otros datos o comentarios que desee agregar: 
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Ciudad: 
11
Email secundario: 
Dirección: 
35
Institución en donde labora: 
85
Departamento o Dependencia: 
70
Breve Resumen del CV (Curriculum Vitae): 
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Tipo de Institución: 
Universidad
Región de salud donde ejerce: 
Los Santos
Género: 
F
Jurisdicción donde desempeña su labor: 
Río Negro