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["附件4"]
["申报专业技术资格单位审核意见表"]
["申报人姓名：","申报资格："]
["一、是否存在以下情况："]
["1.受到行政处分处分期内","□是",null,"□否"]
["2.本年度发生严重有违医德、学术道德等行为","□是",null,"□否"]
["3.在满足年限要求的任职年限内考核不合格","□是",null,"□否"]
["二、学术道德考核情况","□优","□良","□中","□差"]
["三、申报材料审核情况"]
["1.任职年限合格，符合申报基本条件","□是",null,"□否"]
["2.申报信息填写准确无误","□是",null,"□否"]
["3.提供的各类证书等佐证材料真实可靠","□是",null,"□否"]
["4.代表作材料情况属实","□是",null,"□否"]
["四、本人所在单位人事部门审核意见"]
["是否同意个人申报","□是",null,"□否"]
[null,"签章： "]
[null,null,"  年   月   日"]
["五、上级单位人事部门审核意见"]
[]
[null,"签章： "]
[null,null,"  年   月   日"]
["注：签章处由人事部门负责人签字后加盖人事部门印章。"]