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["重庆市乡镇卫生院招聘执业医师报名登记表"]
["姓 名",{"$nulls":3},"性别",null,"出生年月",null,"照片"]
["民 族",{"$nulls":3},"籍贯",null,"政治面貌"]
["学 历",null,"毕业院校及专业"]
["专业技术资格",null,"身份证号"]
["户籍所在地",null,"家庭详细地址"]
["个人联系电话",{"$nulls":4},"电子邮箱"]
["医资格证书编码",{"$nulls":5},"发证    时间"]
["受聘前是否注册执业",{"$nulls":4},"医师执业证书编码"]
["执业证发证时间",null,null,"执业地点"]
["执业范围","□内科 □外科 □妇产科  □儿科  □口腔  □中医 □中西医结合 □其他"]
["执业类别",null,"□临床   □妇产科        □口腔   □中医          ",{"$nulls":3},"专业"]
["受聘前三个月的工作状况：□从事执业范围内相关工作 □从事执业范围外工作 □无业"]
["原工作单位    （地点）",{"$nulls":5},"身份","□正式职工 □临时聘用人员"]
["学习工作简历"]
["招聘去向      (填招聘卫生院及岗位)"]
[null,"是否同意调剂（打√）",{"$nulls":4},"□是  □否"]
["市卫生人才交流中心初审意见"]
["市卫生局\n复核意见"]
["本表一式三份，一份交区县卫生局存档，一份交市卫生人才交流中心存档，一份交市卫生局存档。"]