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["门诊特殊慢性病和公务员特殊疾病申请鉴定表"]
["单位编号:",19800000727,null,null,"个人编号:"]
["姓名",null,"性别",null,"年龄",null,"级别"]
["在职",null,"退休","（   ）","初办",null,"增加","（     ）"]
["单位名称","西安体育学院",{"$nulls":4},"专干电话"," 18502993011"]
["单位性质","公务员单位 (   ) 参照公务员单位（   ）事业单位参加公务员统筹（  ）事业单位（ √）",{"$nulls":4},"个人电话"]
[" 申报慢性病病种",{"$nulls":4}," 原有慢性病病种 "]
[]
[{"$nulls":17},"√"]
[]
["鉴定结果"]
["受理人",{"$nulls":4},"受理日期"]
["鉴定人",{"$nulls":4},"鉴定日期"]
["复审人",{"$nulls":4},"复审日期"]
["备注：","1、“级别”选项按厅级、处级、科级、其它填写，事业单位参加公务员统筹的除医疗照顾人员填写“厅级”外，其它人员可按实际职务填。"]
[null,"2、“申报慢性病病种”处参照慢性病相关文件填写，“原有慢性病病种”系增加病种者填写，初办者不填写。"]
[null,"3、括号内按实际情况打“√”即可。"]

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