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["锦屏县医疗保障社会义务监督员报名登记表"]
["姓名",null,"性别",null,"民族"]
["出生年月",null,"籍贯",null,"政治面貌"]
["现居住地"]
["工作单位",{"$nulls":3},"职务"]
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["联系电话",{"$nulls":3},"电子邮箱"]
["毕业院校\n及学历"]
["主要工作\n经历"]
["受过何种\n奖惩"]
["所在单位\n意见","\n\n\n                             （公章）\n\n                              年   月   日"]
["县医保局\n审查意见","                             \n\n\n\n                             （公章）\n\n                              年   月   日"]

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