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["附件3："]
["宜昌市继续医学教育Ⅰ类、ⅡA类学分审验表（2015年度）"]
["                                      "]
[" 姓名：                性别：                                 ",null," 出生年月："]
["身份证号：",null,"机构人员代码："]
["工作单位：",null,"所在科室："]
["现任专业技术职称：                    ",null,"拟申报专业技术职称："]
["年度","Ⅰ类学分分值","ⅡA类学分分值","合计总分","审验结果"]
[2010]
[2011]
[2012]
[2013]
[2014]
["审验结果：",null,"审验结果："]
[]
[]
[]
[" 单  位（章）",null,"宜昌市继续医学教育委员会办公室（章）"]
["年   月   日",null,"   年   月    日"]