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["中国科学院广州生物医药与健康研究院信息公开申请表\n（法人/其他组织申请表）\n______年第______号"]
["申请人信息","法人/其他组织","名   称"]
[null,null,"组织机构代码",null,"法人代表"]
[null,null,"联系人姓名",null,"联系人电话"]
[null,null,"传    真",null,"联系人手机"]
[null,null,"电子邮箱"]
[null,null,"联系地址/邮编"]
[null,"申请人签名或盖章"]
[null,"申请时间",null,"   年        月       日"]
[null,"所需信息的内容描述"]
[null,"所需信息内容用途类型","1、生产 2、生活 3、科研 4、查验自身相关信息 5、其他"]
[null,"所需信息的用途内容"]
[null,"\n所需信息的指定提供方式（可多选）\n1、纸质\n2、电子邮件\n3、光盘",null,null,"\n获取信息的方式（可多选）\n1、邮寄 \n2、电子邮件 \n3、传真 \n4、自取"]
["备注："]
[null,"\n注：1、“___年第___号”由中国科学院科技战略咨询研究院信息公开办公室填写；\n    2、除“备注”栏外，每栏均为必填项，请认真填写。"]