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["助理医师报考执业医师执业时间及考核合格证明"]
["姓名",null,null,"性别",null,"民族",null,"出生日期"]
["医学学历",null,null,"医学专业",{"$nulls":3},"毕业时间"]
["身份证号码",{"$nulls":6},"报考类别"]
["家庭地址",{"$nulls":6},"邮政编码"]
["工作单位",{"$nulls":6},"业务科室"]
["单位地址",{"$nulls":6},"邮政编码"]
["何年何月首次取得执业助理《医师执业证书》"]
["执业助理医师工作经历"]
["起止日期",null,"执业机构（单位）",null,null,"工作岗位","技术职务","证明人"]
[]
[]
[]
[]
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["以下栏目由执业助理医师所在机构（单位）填写"]
["执业机构（单位）  考核意见",null,"负责人",null,null,"单位公章                                      年    月   日"]
["注意：因本表填写错误或内容不真实所产生的后果概由填表人负责。"]

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