医疗机构依法执业档案(1)

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1、附件2:医疗机构依法执业档案医疗机构名称：监督单位名称：建档期限：年月日—年月日theprovisionsofelectricpowerconstructionengineeringqualitysupervisionandquality...2.4.1.1theunitworksacceptancerateof100%,thequalityevaluationofatotalscoreof95orabove;2.4.1.2regulatedWeldingNDTinspection100%,regulatedweldingapassingrateof>99%,andweldbead

2、appearance;2.4.1.3boilerhydraulic医疗机构简况医疗机构名称：登记号：地址：法定代表人：主要负责人：医疗机构类别：医疗机构性质：床位数（牙椅）：服务对象：所有制形式：注册资金：联系电话：邮政编码：《医疗机构执业许可证》发证机关：《医疗机构执业许可证》有效期限：年月日——年月日《母婴保健技术服务执业许可证》发证机关：《母婴保健技术服务执业许可证》有效期限：年月日——年月日《放射诊疗许可证》发证机关：《放射诊疗许可证》有效期限：年月日——年月日备注：theprovisionsofelectricpowerconstructionengineeringqua

3、litysupervisionandquality...2.4.1.1theunitworksacceptancerateof100%,thequalityevaluationofatotalscoreof95orabove;2.4.1.2regulatedWeldingNDTinspection100%,regulatedweldingapassingrateof>99%,andweldbeadappearance;2.4.1.3boilerhydraulic医疗机构卫生技术人员情况科室姓名职称专业执业证书号合计：医师：护士：其他：注：表格不够，可另行加页theprovision

4、sofelectricpowerconstructionengineeringqualitysupervisionandquality...2.4.1.1theunitworksacceptancerateof100%,thequalityevaluationofatotalscoreof95orabove;2.4.1.2regulatedWeldingNDTinspection100%,regulatedweldingapassingrateof>99%,andweldbeadappearance;2.4.1.3boilerhydraulic卫生技术人员变更情况年度人员变更情况（

5、增加、减少或变更执业范围）年年年年年注：表格不够，可另行加页，无变更情况填写“无”theprovisionsofelectricpowerconstructionengineeringqualitysupervisionandquality...2.4.1.1theunitworksacceptancerateof100%,thequalityevaluationofatotalscoreof95orabove;2.4.1.2regulatedWeldingNDTinspection100%,regulatedweldingapassingrateof>99%,andweldbea

6、dappearance;2.4.1.3boilerhydraulic《医疗机构执业许可证》校验记录校验年度校验日期校验结果合格（）暂缓（）合格（）暂缓（）合格（）暂缓（）合格（）暂缓（）合格（）暂缓（）theprovisionsofelectricpowerconstructionengineeringqualitysupervisionandquality...2.4.1.1theunitworksacceptancerateof100%,thequalityevaluationofatotalscoreof95orabove;2.4.1.2regulatedWeldingNDT

7、inspection100%,regulatedweldingapassingrateof>99%,andweldbeadappearance;2.4.1.3boilerhydraulic《医疗机构执业许可证》变更记录变更日期变更项目变更后情况注：表格不够，可另行加页theprovisionsofelectricpowerconstructionengineeringqualitysupervisionandquality...2.4.1.1theunitworksa