Nimi: __________________________ Soitin: _____________________
Kuukausi: ______________________ Vuosi: _____________________
| vkon pvä | pvä | soi- tin- ko? X | Kauanko? 2min./10min./30min. |
vkon pvä | pvä | soi- tin- ko? X | Kauanko? 2min./10min./30min. | |
|---|---|---|---|---|---|---|---|---|
| ___ | 1. | ☐ | ____________________ | | | ___ | 17. | ☐ | ____________________ |
| ___ | 2. | ☐ | ____________________ | | | ___ | 18. | ☐ | ____________________ |
| ___ | 3. | ☐ | ____________________ | | | ___ | 19. | ☐ | ____________________ |
| ___ | 4. | ☐ | ____________________ | | | ___ | 20. | ☐ | ____________________ |
| ___ | 5. | ☐ | ____________________ | | | ___ | 21. | ☐ | ____________________ |
| ___ | 6. | ☐ | ____________________ | | | ___ | 22. | ☐ | ____________________ |
| ___ | 7. | ☐ | ____________________ | | | ___ | 23. | ☐ | ____________________ |
| ___ | 8. | ☐ | ____________________ | | | ___ | 24. | ☐ | ____________________ |
| ___ | 9. | ☐ | ____________________ | | | ___ | 25. | ☐ | ____________________ |
| ___ | 10. | ☐ | ____________________ | | | ___ | 26. | ☐ | ____________________ |
| ___ | 11. | ☐ | ____________________ | | | ___ | 27. | ☐ | ____________________ |
| ___ | 12. | ☐ | ____________________ | | | ___ | 28. | ☐ | ____________________ |
| ___ | 13. | ☐ | ____________________ | | | ___ | 29. | ☐ | ____________________ |
| ___ | 14. | ☐ | ____________________ | | | ___ | 30. | ☐ | ____________________ |
| ___ | 15. | ☐ | ____________________ | | | ___ | 31. | ☐ | ____________________ |
| ___ | 16. | ☐ | ____________________ | | |
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