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["新兴县计划生育情况审核表"]
["申请人",{"$nulls":4},"配偶姓名",null,null,"审核原因"]
["出生年月",{"$nulls":4},"出生年月"]
["现所在单位",{"$nulls":4},"现所在单位",null,null,"落实避孕措施时间"]
["户口所在地",{"$nulls":4},"户口所在地",null,null,"上环","结扎","其它"]
["婚姻状况",{"$nulls":4},"结婚时间"]
[null,"子女姓名",null,null,"性别","出生年月","是否入户","超生处理情况"]
[1,{"$nulls":6},"征收社会抚养费的单位、时间及金额",null,"给予党纪、政纪处分的单位及时间"]
[2]
[3]
[4]
[5]
["户口所在地村（居）委会计生办或单位意见",null,null,null,"镇人口计生办意见",null,null,"县卫生健康局意见"]
[]
["经办人：",null,null,"（章）","经办人：",null,"（章）","经办人：",null,null,"（章）"]
["     年   月   日",null,null,null,"       年   月   日",null,null,"    年   月   日"]
["   注：1、申请人审核时请携带计划生育有关证件。"]
["       2、此表一式叁份，申请人、镇人口计生办、县卫生健康局各执一份。"]
["       3、本审核表有效期为三个月。"]
["       4、县卫生健康局规划发展信息股联系电话：0766-2982671。"]

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