执业医师变更注册表

执业医师变更注册表 医师变更执业注册 申请 关于撤销行政处分的申请关于工程延期监理费的申请报告关于减免管理费的申请关于减租申请书的范文关于解除警告处分的申请 审核表 姓 名: 医 师 资 格 级 别: 类 别: 医师资格证书编码: 原医师执业证书编码: 新医师执业证书编码: 填表时间: 年 月 日 中华人民共和国卫生部监制 acidity, mL.; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--amount of the volume of sodium hydroxide standard solution, Ml; M--the weight of the sample, g. Such as poor meets the requirements, take the arithmetic mean of the second determination as a result. Results one decimal. 6, allowing differential analyst simultaneously or in quick succession for the second determination, the absolute value of the difference of the results. This value should be no more than 1.0. 1, definitions and principles for determination of ash in starches, starch and ash: starch samples of ash the residue obtained after weight. Original sample residue weight of sample weight or weight expressed as a percentage of the dry weight of the sample. Samples of ash at 900 ? high temperature until ashing sample ... The Crucible: determination of Platinum or other conditions of the affected material, capacity of 50mL. Dryer: has effectively adequate drying agent and-perforated metal plate or porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incineration temperature of 25 c. Analytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparation: Crucible must first wash with boiling dilute hydrochloric acid, then wash with a lot of water and then rinse with distilled water. Wash the Crucible within ashing furnace, heated at 900 to 25 ? 30min, and in the desiccator to cool to room temperature and then weighing, 填 表 说 明 l、本表供变更医师执业注册事项使用。 2、一律用钢笔或毛笔填写～ 内容 财务内部控制制度的内容财务内部控制制度的内容人员招聘与配置的内容项目成本控制的内容消防安全演练内容 要具体、真实～字迹要端正清楚。 3、封面、表1-2由申请人填写～表3-5由有关部门填写～封面的新医师执业证书编码由注册主管部门填写。 4、跨省、自治区、直辖市变更执业注册事项的填写封面的新医师执业证书编码。 5、表内的年月日时间～一律用公历阿拉伯数字填写。 6、申请执业级别请选填执业医师或执业助理医师。 7、申请执业类别请选填临床、中医、口腔或公共卫生。 8、学历应填写与申请类别相应的最高学历。 9、“相片”一律用近期二寸免冠正面半身照。 10、申请变更执业地点的～申请人需在拟变更执业注册事项中填写拟变更的医疗机构的名称～登记号、地址及邮政编码。 11、填写栏目中聘用科目时～申请临床、口腔类别的按《医疗机构诊疗科目名录》一级科目填写;申请中医类别的～按《医疗机构诊疗科目名录》二级科目填写;申请公共卫生类别的～参照公共卫生医师职业分类填写。 12、如填写内容较多～可另加附页。 30min, and in the desiccator to cool to room temperature and then weighing,?furnace, heated at 900 to 25 dilute hydrochloric acid, then wash with a lot of water and then rinse with distilled water. Wash the Crucible within ashing ilingAnalytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparation: Crucible must first wash with bo r porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incineration temperature of 25 c.perforated metal plate o-er conditions of the affected material, capacity of 50mL. Dryer: has effectively adequate drying agent and high temperature until ashing sample ... The Crucible: determination of Platinum or oth?f the sample. Samples of ash at 900 ight oidue obtained after weight. Original sample residue weight of sample weight or weight expressed as a percentage of the dry wee than 1.0. 1, definitions and principles for determination of ash in starches, starch and ash: starch samples of ash the reso morin quick succession for the second determination, the absolute value of the difference of the results. This value should be n thmetic mean of the second determination as a result. Results one decimal. 6, allowing differential analyst simultaneously orthe weight of the sample, g. Such as poor meets the requirements, take the ari--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 1 姓 名 性 别 出生年月 民 族 所学系、专 学 历 业 家庭地址及 邮政编码 专业技术职务 任职资格 身份证号码 原执业机构名称 及登记号 邮政 原执业机构地址 编码 原执业类别 原执业级别 获得执业助理医师 资格的时间 获得执业医师资格 的时间 何时何地因何 种原因受过何 种处罚或处分 d then weighing,ure an 30min, and in the desiccator to cool to room temperat?d water. Wash the Crucible within ashing furnace, heated at 900 to 25 n: Crucible must first wash with boiling dilute hydrochloric acid, then wash with a lot of water and then rinse with distilleion temperature of 25 c. Analytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparatioperforated metal plate or porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incinerat-rying agent anduate ducible: determination of Platinum or other conditions of the affected material, capacity of 50mL. Dryer: has effectively adeq high temperature until ashing sample ... The Cr?ssed as a percentage of the dry weight of the sample. Samples of ash at 900 expre h and ash: starch samples of ash the residue obtained after weight. Original sample residue weight of sample weight or weightthe results. This value should be no more than 1.0. 1, definitions and principles for determination of ash in starches, starcce of g differential analyst simultaneously or in quick succession for the second determination, the absolute value of the differenoor meets the requirements, take the arithmetic mean of the second determination as a result. Results one decimal. 6, allowinthe weight of the sample, g. Such as p--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 2 个 人 工 作 经 历 时 间 单 位 技术职务 证 明 人 身体和健康 状况 其他要说 明的问题 申请人签字: 年 月 日 30min, and in the desiccator to cool to room temperature and then weighing,?furnace, heated at 900 to 25 dilute hydrochloric acid, then wash with a lot of water and then rinse with distilled water. Wash the Crucible within ashing ilingAnalytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparation: Crucible must first wash with bo r porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incineration temperature of 25 c.perforated metal plate o-er conditions of the affected material, capacity of 50mL. Dryer: has effectively adequate drying agent and high temperature until ashing sample ... The Crucible: determination of Platinum or oth?f the sample. Samples of ash at 900 ight oidue obtained after weight. Original sample residue weight of sample weight or weight expressed as a percentage of the dry wee than 1.0. 1, definitions and principles for determination of ash in starches, starch and ash: starch samples of ash the reso morin quick succession for the second determination, the absolute value of the difference of the results. This value should be n thmetic mean of the second determination as a result. Results one decimal. 6, allowing differential analyst simultaneously orthe weight of the sample, g. Such as poor meets the requirements, take the ari--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 3 拟变更注册 事项 变更注册 理由 申请人签字: 年 月 日 原执业机构 意见 印 章 负责人: 年 月 日 原执业机构 上级主管部 门审批意见 印 章 负责人: 年 月 日 d then weighing,ure an 30min, and in the desiccator to cool to room temperat?d water. Wash the Crucible within ashing furnace, heated at 900 to 25 n: Crucible must first wash with boiling dilute hydrochloric acid, then wash with a lot of water and then rinse with distilleion temperature of 25 c. Analytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparatioperforated metal plate or porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incinerat-rying agent anduate ducible: determination of Platinum or other conditions of the affected material, capacity of 50mL. Dryer: has effectively adeq high temperature until ashing sample ... The Cr?ssed as a percentage of the dry weight of the sample. Samples of ash at 900 expre h and ash: starch samples of ash the residue obtained after weight. Original sample residue weight of sample weight or weightthe results. This value should be no more than 1.0. 1, definitions and principles for determination of ash in starches, starcce of g differential analyst simultaneously or in quick succession for the second determination, the absolute value of the differenoor meets the requirements, take the arithmetic mean of the second determination as a result. Results one decimal. 6, allowinthe weight of the sample, g. Such as p--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 4 原注册卫 生行政部门 审批意见 印 章 负责人: 年 月 日 级别: 拟执业机构 类别: 意见 拟聘用科目: 印 章 负责人: 年 月 日 拟执业机构 级别: 上级主管部 类别: 门审批意见 拟聘用科目: 印 章 负责人: 年 月 日 30min, and in the desiccator to cool to room temperature and then weighing,?furnace, heated at 900 to 25 dilute hydrochloric acid, then wash with a lot of water and then rinse with distilled water. Wash the Crucible within ashing ilingAnalytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparation: Crucible must first wash with bo r porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incineration temperature of 25 c.perforated metal plate o-er conditions of the affected material, capacity of 50mL. Dryer: has effectively adequate drying agent and high temperature until ashing sample ... The Crucible: determination of Platinum or oth?f the sample. Samples of ash at 900 ight oidue obtained after weight. Original sample residue weight of sample weight or weight expressed as a percentage of the dry wee than 1.0. 1, definitions and principles for determination of ash in starches, starch and ash: starch samples of ash the reso morin quick succession for the second determination, the absolute value of the difference of the results. This value should be n thmetic mean of the second determination as a result. Results one decimal. 6, allowing differential analyst simultaneously orthe weight of the sample, g. Such as poor meets the requirements, take the ari--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 5 卫生行政部门执业机构及登记号: 的审批意见 机构地址及邮编: 级别: 类别: 聘用的科目: 印 章 负责人: 年 月 日 执业医师 医师执业证书 编码 执业助理医师 备 注 d then weighing,ure an 30min, and in the desiccator to cool to room temperat?d water. Wash the Crucible within ashing furnace, heated at 900 to 25 n: Crucible must first wash with boiling dilute hydrochloric acid, then wash with a lot of water and then rinse with distilleion temperature of 25 c. Analytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparatioperforated metal plate or porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incinerat-rying agent anduate ducible: determination of Platinum or other conditions of the affected material, capacity of 50mL. Dryer: has effectively adeq high temperature until ashing sample ... The Cr?ssed as a percentage of the dry weight of the sample. Samples of ash at 900 expre h and ash: starch samples of ash the residue obtained after weight. Original sample residue weight of sample weight or weightthe results. This value should be no more than 1.0. 1, definitions and principles for determination of ash in starches, starcce of g differential analyst simultaneously or in quick succession for the second determination, the absolute value of the differenoor meets the requirements, take the arithmetic mean of the second determination as a result. Results one decimal. 6, allowinthe weight of the sample, g. Such as p--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 6 医师注册健康检查表 指定体检医院名称: 体检日期: 年 月 日 姓 名 性别 出生日期 近 工作单位 照 出 生 地 民 族 既往病史 体检单位骑 缝章 家 庭 史 医师签字: 甲 状 腺 脊柱 淋 巴 四肢 外 肛 门 关节 科 泌尿生殖器 其 它 医师签字: 血 压 神经及精神 肺及呼吸道 内 心脏及血管 科 肝 腹部器官 脾 其 它 胸部X线透视 医师签字: 心 电 图 医师签字: 转 氨 酶 乙肝表面抗原 化验员签字: 30min, and in the desiccator to cool to room temperature and then weighing,?furnace, heated at 900 to 25 dilute hydrochloric acid, then wash with a lot of water and then rinse with distilled water. Wash the Crucible within ashing ilingAnalytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparation: Crucible must first wash with bo r porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incineration temperature of 25 c.perforated metal plate o-er conditions of the affected material, capacity of 50mL. Dryer: has effectively adequate drying agent and high temperature until ashing sample ... The Crucible: determination of Platinum or oth?f the sample. Samples of ash at 900 ight oidue obtained after weight. Original sample residue weight of sample weight or weight expressed as a percentage of the dry wee than 1.0. 1, definitions and principles for determination of ash in starches, starch and ash: starch samples of ash the reso morin quick succession for the second determination, the absolute value of the difference of the results. This value should be n thmetic mean of the second determination as a result. Results one decimal. 6, allowing differential analyst simultaneously orthe weight of the sample, g. Such as poor meets the requirements, take the ari--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 7 医师签字: 右 右 视 矫正 其它 眼 力 视力 眼疾 左 左 右 五 听 耳 耳 力 疾 官 左 鼻及鼻窦 科 疾 病 咽 喉 其 它 主 (以下部分请在符合的项目上用“?”表示:) 检 结果: 1.健康或良好 2.一般或较弱 3.有慢性病 结 (若有慢性病请继续在下列符合的项目上用“?”表示:) 果 1.心血管病 6.结核病 2.脑血管病 7.糖尿病 3.慢性呼吸系统病 8.神经或精神疾病 4.慢性消化系统病 9.其它慢性病(具体): 5.慢性肾炎 体检医院盖章 主检医师签字: 填写日期: 年 月 日 注 册 机 注册机关盖章 关 意 填报日期: 年 月 日 见 注:1.表中内容请体检单位如实工整填写，不得涂改，不得弄虚作假。 2.体检后此表交注册机关。 d then weighing,ure an 30min, and in the desiccator to cool to room temperat?d water. Wash the Crucible within ashing furnace, heated at 900 to 25 n: Crucible must first wash with boiling dilute hydrochloric acid, then wash with a lot of water and then rinse with distilleion temperature of 25 c. Analytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparatioperforated metal plate or porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incinerat-rying agent anduate ducible: determination of Platinum or other conditions of the affected material, capacity of 50mL. Dryer: has effectively adeq high temperature until ashing sample ... The Cr?ssed as a percentage of the dry weight of the sample. Samples of ash at 900 expre h and ash: starch samples of ash the residue obtained after weight. Original sample residue weight of sample weight or weightthe results. This value should be no more than 1.0. 1, definitions and principles for determination of ash in starches, starcce of g differential analyst simultaneously or in quick succession for the second determination, the absolute value of the differenoor meets the requirements, take the arithmetic mean of the second determination as a result. Results one decimal. 6, allowinthe weight of the sample, g. Such as p--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 8 医疗、预防、保健机构聘用证明 姓名: 性别: 年龄: 医师级别(执业、助理): 医师类别(临床、口腔、公卫、中医): 医师资格证书编码: 受聘专业(按医师注册执业范围填写): 受聘时间: 拟聘期限: 聘用单位意见: 法人签字: 单位公章: 年 月 日 注:本表一式二份，一份交注册主管部门，一份留存聘用单位。 30min, and in the desiccator to cool to room temperature and then weighing,?furnace, heated at 900 to 25 dilute hydrochloric acid, then wash with a lot of water and then rinse with distilled water. Wash the Crucible within ashing ilingAnalytical balance. Electric hot plate or Bunsen. 3, crucible of analysis steps preparation: Crucible must first wash with bo r porcelain. Ashing furnaces: device for controlling and regulating temperature, offers 900 incineration temperature of 25 c.perforated metal plate o-er conditions of the affected material, capacity of 50mL. Dryer: has effectively adequate drying agent and high temperature until ashing sample ... The Crucible: determination of Platinum or oth?f the sample. Samples of ash at 900 ight oidue obtained after weight. Original sample residue weight of sample weight or weight expressed as a percentage of the dry wee than 1.0. 1, definitions and principles for determination of ash in starches, starch and ash: starch samples of ash the reso morin quick succession for the second determination, the absolute value of the difference of the results. This value should be n thmetic mean of the second determination as a result. Results one decimal. 6, allowing differential analyst simultaneously orthe weight of the sample, g. Such as poor meets the requirements, take the ari--amount of the volume of sodium hydroxide standard solution, Ml; M--calibration of the molar concentration of sodium hydroxide standard solution, moI/L; V--acidity, mL.; M 9