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["附件2"]
[" 六盘水市中医医院面向社会公开招聘编制外工作人员报名审核表"]
["一、申请人基本信息"]
["姓名",null,"性别",null,"民族",null,"出生年月",null,"照片"]
["政治面貌",null,"职称",null,"学历",null,"专业"]
["籍贯",{"$nulls":3},"户籍所在地"]
["联系电话",{"$nulls":3},"电子邮箱"]
["申报岗位"]
[" 二、学习及工作经历"]
["学习实习经历","起止年月","毕业院校、专业、任职情况（大学开始填写）"]
[]
["工作、进修经历","起止年月","工作单位、科室、任职情况"]
[]
[]
["取得执业证注册范围、注册地点",null,"是否取得执业证书     是     否；执业证书编号：                                          注册地点：                                                                     注册范围：                                                           "]
["规范化培训","规培地点                                                                           规培时间                                                                                      规培专业                                                                      "]
["考生签名：                                                                                                日期：",{"$nulls":3},"资格初审人员签名：                                                                                            日期：",null,null,"资格复审人员签名：                                                                                            日期："]
["个人声明：本人保证提交信息的真实性，承担因填写不实而产生的一切后果。"]

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