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<li id="c_h1">《生育服务证》申请表</li>
<li id="c_h2"><span>来源：县计生局 点击次数?script type="text/javascript" src="http://search.qjdwgk.gov.cn/click/default.ashx?id=8288"></script> 发布日期?013-01-28</span></li>
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<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"> </p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 18pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">《生育服务证》申请表</span></span></p>
<table class="msonormaltable" style="margin-left: auto; margin-right: auto; border-collapse: collapse; mso-border-alt: solid black .5pt; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-border-insideh: .5pt solid black; mso-border-insidev: .5pt solid black; mso-table-layout-alt: fixed;" border="1" cellspacing="0" cellpadding="0">
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<tr style="height: 20.6pt; mso-yfti-irow: 0; mso-yfti-firstrow: yes;">
<td style="padding-right: 5.4pt; padding-left: 5.4pt; padding-bottom: 0cm; width: 77.4pt; padding-top: 0cm; height: 20.6pt; background-color: transparent; mso-border-alt: solid black .5pt; border: black 1pt solid;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">姓名</span></span></span></p>
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<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: black 1pt solid; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.6pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">（女?/span></span></span></p>
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<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: black 1pt solid; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.6pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">（男?/span></span></span></p>
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<tr style="height: 21.7pt; mso-yfti-irow: 1;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 21.7pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">民族</span></span></span></p>
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<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 21.7pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 21.7pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
</td>
</tr>
<tr style="height: 20.55pt; mso-yfti-irow: 2;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.55pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">工作单位</span></span></span></p>
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<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.55pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.55pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
</td>
</tr>
<tr style="height: 20.95pt; mso-yfti-irow: 3;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.95pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">身份证号</span></span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.95pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.95pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
</td>
</tr>
<tr style="height: 20.65pt; mso-yfti-irow: 4;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.65pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">户籍地地址</span></span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.65pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.65pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
</td>
</tr>
<tr style="height: 20.65pt; mso-yfti-irow: 5;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.65pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">农转?/span></span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.65pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 10.5pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">转户时间<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.65pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: tahoma;"><span style="font-size: 10.5pt; font-family: 方正小标宋简?">转户时间<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
</tr>
<tr style="height: 20.35pt; mso-yfti-irow: 6;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.35pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">户籍性质</span></span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.35pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: tahoma;"><span style="font-size: 10pt; font-family: 方正小标宋简?">农业人口 </span><span style="font-size: 10pt; font-family: 方正小标宋简? mso-hansi-font-family: 微软雅黑;">?/span><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="mso-spacerun: yes;"> </span></span><span style="font-size: 10pt; font-family: 方正小标宋简?">非农业人?/span><span style="font-size: 10pt; font-family: 方正小标宋简? mso-hansi-font-family: 微软雅黑;">?/span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.35pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: tahoma;"><span style="font-size: 10pt; font-family: 方正小标宋简?">农业人口</span><span style="font-size: 10pt; font-family: 方正小标宋简? mso-hansi-font-family: 微软雅黑;">?/span><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span><span style="font-size: 10pt; font-family: 方正小标宋简?">非农业人?/span><span style="font-size: 10pt; font-family: 方正小标宋简? mso-hansi-font-family: 微软雅黑;">?/span></span></p>
</td>
</tr>
<tr style="height: 49.8pt; mso-yfti-irow: 7;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 49.8pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?" lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">婚姻状况</span></span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 49.8pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: tahoma;"><span style="font-size: 10pt; font-family: 方正小标宋简?">初婚 <span style="mso-spacerun: yes;"> </span></span><span style="font-size: 10pt; font-family: 方正小标宋简? mso-hansi-font-family: 微软雅黑;">?/span><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span><span style="font-size: 10pt; font-family: 方正小标宋简?">再婚 </span><span style="font-size: 10pt; font-family: 方正小标宋简? mso-hansi-font-family: 微软雅黑;">?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">结婚时间<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">结婚证号</span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 49.8pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: tahoma;"><span style="font-size: 10pt; font-family: 方正小标宋简?">初婚 <span style="mso-spacerun: yes;"> </span></span><span style="font-size: 10pt; font-family: 方正小标宋简? mso-hansi-font-family: 微软雅黑;">?/span><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="mso-spacerun: yes;"> </span></span><span style="font-size: 10pt; font-family: 方正小标宋简?">再婚 </span><span style="font-size: 10pt; font-family: 方正小标宋简? mso-hansi-font-family: 微软雅黑;">?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">结婚时间<span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">结婚证号</span></span></p>
</td>
</tr>
<tr style="height: 49.2pt; mso-yfti-irow: 8;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 49.2pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?" lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">生育情况</span></span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 180pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 49.2pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="240">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">现有子女?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">最大孩子出生时?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">最小孩子出生时?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 168.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 49.2pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="225">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">现有子女?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">最大孩子出生时?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?<span style="mso-spacerun: yes;"> </span>?<span style="mso-spacerun: yes;"> </span>?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: tahoma;"><span style="font-size: 10pt; font-family: 方正小标宋简?">最小孩子出生时?<span style="mso-spacerun: yes;"> </span><span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?<span style="mso-spacerun: yes;"> </span>?<span style="mso-spacerun: yes;"> </span>?/span></span></p>
</td>
</tr>
<tr style="height: 20.6pt; mso-yfti-irow: 9;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 77.4pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.6pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" valign="top" width="103">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">申请事项</span></span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 348.7pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 20.6pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="3" valign="top" width="465">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">请安排在?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>）年度生育，并核发第?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>）孩生育服务?/span></span></span></p>
</td>
</tr>
<tr style="height: 22.2pt; mso-yfti-irow: 10;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 426.1pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 22.2pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="4" valign="top" width="568">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?<span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></span></p>
</td>
</tr>
<tr style="height: 99.3pt; mso-yfti-irow: 11;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 218.05pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 99.3pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="291">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">女方户籍地村（居）委会意?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<br style="mso-ignore: vglayout;" clear="all" />
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">经办人：<span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 208.05pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 99.3pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="277">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-indent: 10pt; text-align: center; mso-char-indent-count: 1.0;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">男方户籍地村（居）委会意?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="text-justify: inter-ideograph; margin: 0cm 0cm 10pt; text-indent: 5pt; text-align: justify; mso-char-indent-count: .5;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">经办人：<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
</tr>
<tr style="height: 101.4pt; mso-yfti-irow: 12;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 218.05pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 101.4pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="291">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">女方户籍地乡（镇）、街道意?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<br style="mso-ignore: vglayout;" clear="all" />
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">经办人：<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 208.05pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 101.4pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="277">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">男方户籍地乡（镇）、街道意?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-indent: 5pt; mso-char-indent-count: .5;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">经办人：<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
</tr>
<tr style="height: 111.85pt; mso-yfti-irow: 13;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 218.05pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 111.85pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="291">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-indent: 25pt; mso-char-indent-count: 2.5;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">女方户籍地县级计生行政部门意?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<br style="mso-ignore: vglayout;" clear="all" />
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"><span style="mso-tab-count: 1;"> </span></span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">经办人：<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: #ebe9ed; width: 208.05pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 111.85pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="2" valign="top" width="277">
<p class="msonormal" style="margin: 0cm 0cm 0pt; text-indent: 25pt; mso-char-indent-count: 2.5;"><span style="font-family: tahoma;"><span style="font-size: 10pt; font-family: 方正小标宋简?">男方户籍地县级计生行政部门意?/span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt;"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-align: center;" align="center"><span style="font-size: 10pt; font-family: 方正小标宋简?" lang="en-us"><span style="font-family: tahoma;"> </span></span></p>
<p class="msonormal" style="margin: 0cm 0cm 10pt; text-indent: 10pt; mso-char-indent-count: 1.0;"><span style="font-size: 10pt; font-family: 方正小标宋简?"><span style="font-family: tahoma;">经办人：<span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?span lang="en-us"><span style="mso-spacerun: yes;"> </span></span>?/span></span></p>
</td>
</tr>
<tr style="height: 19.45pt; mso-yfti-irow: 14; mso-yfti-lastrow: yes;">
<td style="border-right: black 1pt solid; padding-right: 5.4pt; border-top: #ebe9ed; padding-left: 5.4pt; padding-bottom: 0cm; border-left: black 1pt solid; width: 426.1pt; padding-top: 0cm; border-bottom: black 1pt solid; height: 19.45pt; background-color: transparent; mso-border-alt: solid black .5pt; mso-border-top-alt: solid black .5pt;" colspan="4" valign="top" width="568">
<p class="msonormal" style="margin: 0cm 0cm 0pt; tab-stops: center 207.65pt;"><span style="font-family: 方正小标宋简?"><span style="font-size: medium;"><span style="font-family: tahoma;">发证时间<span lang="en-us"><span style="mso-tab-count: 1;"> </span></span>生育服务证号</span></span></span></p>
</td>
</tr>
<tr>
<td style="background-color: transparent; border: #ebe9ed;" width="103"> </td>
<td style="background-color: transparent; border: #ebe9ed;" width="188"> </td>
<td style="background-color: transparent; border: #ebe9ed;" width="52"> </td>
<td style="background-color: transparent; border: #ebe9ed;" width="225"> </td>
</tr>
</tbody>
</table>
<p class="msonormal" style="margin: 0cm 0cm 10pt;" align="center"><span lang="en-us"><span style="font-size: medium; font-family: tahoma;"> </span></span></p>
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