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设置医疗机构申请书被申请机关:设置单位(人): 地址:联系人: :申请核定项目类 别名 称选 址所有制形式经营性质床位(牙椅)服务对象诊疗科目投资总额其 他提交文件目录:⑴⑵⑶⑷⑸⑹⑺⑻设置单位(人): (章)年 月
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