医疗机构卫生监督管理档案1

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1、医疗机构卫生监督管理档案监督机构名称：医疗机构名称：建档期限：年月日—年月日ofwork,relationships,needandpossibility,putqualityfirst."Improvestructure",referspartycarefully".IsamustadheretotheindividualabsorptionTheprincipleofthedevelopmentofamatureone,andstrictlyperformintheadmissionprocedure,topreventthePartymember15医疗机构简况

2、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：ofwork,relationships,needandpossibility,putqualityfirst."Improvestructure",refersparty

3、carefully".IsamustadheretotheindividualabsorptionTheprincipleofthedevelopmentofamatureone,andstrictlyperformintheadmissionprocedure,topreventthePartymember15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ofwork,relationships,needandpossibility,putqualityfirst."Improvestructure",refersp

4、artycarefully".IsamustadheretotheindividualabsorptionTheprincipleofthedevelopmentofamatureone,andstrictlyperformintheadmissionprocedure,topreventthePartymember15卫生技术人员变更情况年度人员变更情况（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”ofwork,relationships,needandpossibility,putqualityfirst."Improvest

5、ructure",referspartycarefully".IsamustadheretotheindividualabsorptionTheprincipleofthedevelopmentofamatureone,andstrictlyperformintheadmissionprocedure,topreventthePartymember15《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（）ofwork,relationships,needandpossibility,put

6、qualityfirst."Improvestructure",referspartycarefully".IsamustadheretotheindividualabsorptionTheprincipleofthedevelopmentofamatureone,andstrictlyperformintheadmissionprocedure,topreventthePartymember15《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ofwork,relationships,needandpossibility,putqual

7、ityfirst."Improvestructure",referspartycarefully".IsamustadheretotheindividualabsorptionTheprincipleofthedevelopmentofamatureone,andstrictlyperformintheadmissionprocedure,topreventthePartymember15医疗机构执业许可证（副本）粘贴线ofwork,relationships,needandpossibility,putqualityfirst."Improvest