Version201002助产机构内助产机构内助产机构内助产机构内《《《《出生医学
证明
住所证明下载场所使用证明下载诊断证明下载住所证明下载爱问住所证明下载爱问
出生医学证明出生医学证明出生医学证明》》》》首次签发
登记表
调解登记表下载应聘登记表下载调解登记表下载调解登记表下载调解登记表下载
首次签发登记
表
关于同志近三年现实表现材料材料类招标技术评分表图表与交易pdf视力表打印pdf用图表说话 pdf
首次签发登记表首次签发登记表RegistrationFormforFirstIssuanceofBirthCeRegistrationFormforFirstIssuanceofBirthCeRegistrationFormforFirstIssuanceofBirthCeRegistrationFormforFirstIssuanceofBirthCertificateinDeliveryInstitutertificateinDeliveryInstitutertificateinDeliveryInstitutertificateinDeliveryInstitute分娩信息Newborn’sBirthInformation产妇姓名NameofNewborn’sMother住院病历号InpatientMR#接生机构DeliveryInstitution新生儿性别Newborn’sSex出生日期DateofBirth年月日时分YYMMDDHHMM出生地PlaceofBirth省市县（区）乡ProvinceCityCounty出生孕周Gestationalweek周Week体重Weight克(g)身长Height厘米(cm)分娩方式DeliveryMode健康状况StateofHealth良好一般差GoodModerateBad胎数NumberofFetus备注Remarks以上内容由接生人员填写，请核对正确无误后签字确认。Theaboveinformationshouldbecompletedbythemidwife/doctor.Pleasecheckbeforesigning.接生人签字Midwife/doctor’ssignature:填表日期SigningDate:年YY/月MM/日DD/新生儿姓名及其父母相关信息Newborn’sname&Parents’information新生儿姓名Newborn’sName户口RegisteredPermanentResidence随父随母WithfatherWithmother姓名Name年龄Age国籍Nationality民族Race有效身份证件类别IdentityCardType有效身份证件号码IdentityCardNo.母亲信息Mother’sInformation户口地址RegisteredAddress姓名Name年龄Age国籍Nationality民族Race有效身份证件类别IdentityCardType有效身份证件号码IdentityCardNo.父亲信息Father’sInformation户口地址RegisteredAddress现住址及联系电话Presentaddress&Contactinformation姓名Name与新生儿关系Relationshipswiththenewborn有效身份证类别IdentityCardType领证人Recipient有效身份证号码IdentityCardNo.以上内容由领证人填写，请核对正确无误后签字确认，并承担相应法津责任。《出生医学证明》一经签发，证件上的各项信息不应变更。Theaboveinformationshouldbecompletedbytherecipientwhowillbearthelegalliability.Pleasecheckbeforesigningbelow.Oncethebirthcertificateisissued,theinformationonthecertificatewillbepermanent.领证人签字Recipient’ssignature:填表日期SigningDate：年YY/月MM/日DD/《出生医学证明》存根粘贴处Pleaseattachthestubofthebirthcertificatehere特殊情况
说明
关于失联党员情况说明岗位说明总经理岗位说明书会计岗位说明书行政主管岗位说明书
SpecialStatementsifapplicable领证人签字Recipient’sSignature:填表日期SigningDate:年YY/月MM/日DD/注Notes：1、填写首次签发登记表时，需提供新生儿父母身份证和户口本等有效证件原件Whilefillingtheformabove,theoriginaleffectiveidentitycardsoftheparentsshouldbepresented2、表中分娩信息和新生儿姓名及其父母相关信息分别由接生人员和领证人填写，所有项目要字迹清楚若出现涂改，相应内容须由接生人员或领证人签字确认。Theinformationaboveshouldbecompletedbythemidwifeandtherecipientordoctorrespectively.Aclearhandwritingisrequired.Anymodificationshouldbeconfirmedbythemidwife/doctorortherecipientwithsignature.3、请将《出生医学证明》存根粘贴在此表相应位置永久保存。Thebirthcertificatestubshouldbeattachedattheappointedplaceforpermanentpreservation
浙公网安备 33021202002483