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["附件4："]
["仁怀市人民医院医共体茅坝分院\n2023年公开遴选编外专业技术人员报名表"]
["报考岗位：                                   ",{"$nulls":8},"照片"]
["姓 名",null,"身份证号",{"$nulls":4},"出生年月"]
["政治面貌",null,"性别",null,"身高",null,"民族"]
["籍 贯",null,"户口所在地",{"$nulls":3},"婚姻状况"]
["通讯地址",{"$nulls":5},"联系电话"]
["毕业院校",{"$nulls":3},"学  历",{"$nulls":3},"学 位"]
["专业",null,"毕业时间",{"$nulls":5},"执业资格"]
["个人简历","  "]
["报名信息确认栏",null,"    以上填写信息及提交的资料均为本人真实情况，若有虚假、遗漏、错误，责任自负。                                "]
[null,null,"      考生确认签字：             日期："]
["初审意见",null,"                     审核签字：               日期："]