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["安徽新华学院2017级新生体检投标报名表"]
["一、服务提供单位报名信息"]
["单位名称："]
["联系方式：","姓名",null,"电话："]
["完成周期"]
["授权承诺：","（盖章有效）"]
["二、检查项目分类报价"]
["序号","检查项目",null,"检查费用","检查说明","相关备注"]
[1,"机能","血压（mmhg）"]
[2,"形态","身高(cm)"]
[null,null,"体重(kg)"]
[3,"眼科","视力(裸眼分左右)"]
[null,null,"辨色力"]
[null,null,"其他"]
[4,"耳","耳病左耳"]
[null,null,"耳病右耳"]
[5,"鼻","鼻病"]
[6,"口腔科","龋齿"]
[null,null,"扁桃体"]
[null,null,"其他"]
[7,"外科","甲状腺"]
[null,null,"胸"]
[null,null,"脊柱"]
[null,null,"四肢"]
[null,null,"平足"]
[null,null,"皮肤"]
[null,null,"淋巴结"]
[null,null,"疝"]
[null,null,"肛门"]
[null,null,"其他"]
[8,"内科","心"]
[null,null,"肺"]
[null,null,"肝"]
[null,null,"脾"]
[null,null,"其他"]
[9,"化验","肝功能(GPT)"]
[null,null,"乙肝表面搞原"]
[null,null,"血型"]
[10,"胸透","胸透"]
[]
["注：\n1、“既往病史”过去患有本项目中列出的某种疾病者，在该病外画“√”号，地方病应注病名。\n2、各项检查结果无阳性发现者可填“/”,发现阳性结果，可填病句或阳性体征。形态记录整数后小数点一位，机能、视力、龋齿、血红蛋白等项记录填具体数据。\n3、检查医师检查完毕签名（签在各科空格栏内），以示负责。\n"]

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