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["附件2:"]
["体检确认表"]
["姓  名",null,null,"性  别",null,"出生年月",null,"照\n片"]
["民  族",null,null,"婚姻状况",null,"籍  贯"]
["文化程度",null,null,"联系电话"]
["职  业",null,null,"工作单位\n（毕业院校）"]
["岗位代码",null,null,"身份证号"]
["请本人如实详细填写下列项目\n（在每一项后的空格中打“√”回答“有”或“无”，如故意隐瞒，后果自负）"]
["病  名","有","无","治愈时间","病  名","有","无","治愈时间"]
["高血压病",{"$nulls":3},"糖尿病"]
["冠心病",{"$nulls":3},"甲亢"]
["风心病",{"$nulls":3},"贫血"]
["先心病",{"$nulls":3},"癫痫"]
["心肌病",{"$nulls":3},"精神病"]
["支气管扩张",{"$nulls":3},"神经官能症"]
["支气管哮喘",{"$nulls":3},"吸毒史"]
["肺气肿",{"$nulls":3},"急慢性肝炎"]
["消化性溃疡",{"$nulls":3},"结核病"]
["肝硬化",{"$nulls":3},"性传播疾病"]
["胰腺疾病",{"$nulls":3},"恶性肿瘤"]
["急慢性肾炎",{"$nulls":3},"手术史"]
["肾功能不全",{"$nulls":3},"严重外伤史"]
["结缔组织病",{"$nulls":3},"其他"]
["备  注："]
["受检者签字：\n                                               体检日期：     年     月     日"]