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	NOTATKA SŁUŻBOWA ZE SPOTKANIA W .............................................................................................................................................................................................. W DNIU ...............................................
W spotkaniu udział wzięli: .......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... (wymienić).
Celem spotkania było:  ...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... . Ustalono, że: ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... . Wnioski:................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ (w tym komu przekazać tę notatkę).

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(pieczątka i podpis)