Խⷿͬģ壨ѡ15ƪ
ֽܶάȨʶڲǿԽԽijͳҪõͬͬǶ˫ıһԼôʽ淶ĺͬʲôأСྫԽⷿͬģ壬ϣܹҡ
Խⷿͬ 1
ⷽ(¼Ƽ)_____ϵʽ_______________
ⷽ(¼ҷ)_____ϵʽ_______________
ָͬȨ˽ݽʹá棬֧ĺͬݡͬطɵĹ涨ס˫зݵЭ飺
һⷿ(¼Ƹ÷)_____ݽṹΪ_____Ȩ֤_____ƽף()Ȩ֤š
ڶ÷;Ϊ˫Լ⣬ҷøı䷿;
______________________________ֹ
÷Ϊ(д)_____Ԫͬ䡣
(¡)㣬ÿ(¡)(ֽת)
ڱͬЧ֮
ڸ÷ݵȨˣŵȨйص»ףͬЧɼеȫΣɴ˸ҷɾʧģɼ⳥
ڰǷҷת÷(ڿոдǻ)
ھڼķάɼҷʹòɵʧάҷе
ʮҷڼķȫǰۺȫȹҷӦִейزŵĹ涨еȫκͷӼල顣
ʮһͬҷڲı䷿ݽṹǰ£Ͷʶݽװװޣװװ뾭ǩͬ⡣ҷάװװ״ݵģװװãҷװװ豸ϵģʻָԭ
ʮڷڼ䣬ʹ÷йصķҷ֧ҷеڸΥԼΡҷ֧ķΪˮѣѣ绰ѣúѣߵӷѣѣҵѵȡ
ʮֹͬҷպͬս˻
ʮҷ֮һ'ֹͬջطݣɼʧҷ⳥
1Խķתģ
2Բijⷿݽṹıⷿ;ģ
3Ƿۼƴµģ
4Υʮ涨αģ
5óⷿݽΥģ
6ⷿݵģ
7ʮڼ䣬κһֹͬǰ֪ͨԷ˫Э̺ǩֹͬ飬ֹͬǩǰͬЧ
ʮݵģӦڳ֮ǰ֪ͨˣͬȹȨڼ䷢Ȩ䶯ģӰͬЧ
ʮڼ˫غͬκһΥͬԼ%еΥԼΡҷڽģܶ%ռɽ
ʮͬδɼס˫Э̣ǩЭ顣Э뱾ͬһµģԲЭΪ
ʮȨ֤ӡոдӡˢ־ͬЧ
ڶʮ
ڶʮһͬз飬ɼס˫Э̽Ҳ뵱ع̲ŵ⡣Э̻ⲻʱе_____
1ύٲίԱٲã_____
2Ժߡ
ڶʮͬͬҳһʽݣ˫ִһݣͬݡ
ڶʮͬǩ֮Ч
()_________
ҷ()_________
(ǩ)_________
(ǩ)_________
_________________
_________________
Խⷿͬ 2
ⷽ_________
֤ţ_________
ҷⷽ_________
֤ţ_________
ݡлͬлзزйطɡ涨ƽȡԸЭһµĻϣס˫зݵЭ飺
1ԸСԪҵ˽סҷΪסʹã˫Լ⣬ҷı䷿;
2ҷڱ뱣ֺͰԭݽṹͷʩԲռ⳥еΣ
3ҷΥԼͼΥΪԸ
4ҷڼ`ˮ硢ѣ·ӷ/ѼӦزţǷɵɽҷ
5ÿΪǪʰԪңҷÿɷڽǰ15츶Ѻ𣩡ڼ䣬г仯˫Э̵֮⣬ⷽκ
6__________________ֹ
7ʽҷһԽ__ԪѺ__ԪҴд_________Ԫڷ⽻Լÿ½һΣ_________ԪҷӦڵڷǰ_________һԽͬǩЧ
8Ϊ˼˫棬粻⡢תҷⶼǰ֪ͨԷͬ£ҷȨ
9ͬס˫ȨֹͬҷδΥǰ¡˻Ѻҷ˫ΥΥԼӦеԼһоʧ
10ͬЧΪֹͬһʽݣδˣ˫Э̽
11ΥԼ
1ڼ˫غͬҷΥͬĹ涨۳ҷһΪΥԼֹͬ
2ҷԽⷿתʹãȨֹͣתΪֹͬͬʱ۳ҷȫѺͬǸ̬ԾǷƽعء
3ɿԭ¸÷ݻʧģ˫ͬȷϿɣҷɲеӦΡ
4ͬδɼס˫鶨
5ͬ丽ͲЭδ涨лйطɡִС
12Լ
һʼʱˮ硢úȱ״
1ˮΪ_________ȣ
2Ϊ_________ȣ
3úΪ_________ȣ
4ҷӦǷýȫõϿɡ
ṩҷƷ£
1װǰú̻ȼˮϴ̨뻧Կװѣ
2ɳһš輸һӹһһš͵ĸ¹һд̨һԴһš
3ҷӦ֤ݼʩƷãʧҷӦʱ䣬ԭ35۸Ѻп۳羭պϸʱӦ˻ҷʣⷿѺ
4ҷӦṩЧ֤ĸӡ1ݼЧϵʽ
13ͬз飬ɼס˫Э̽Э̲ʱס˫Ժߡ
14ͬԼס˫ǩ֮Чһʽݣס˫ִһݣͬЧ
ǩ֣_________
ҷǩ֣_________
ǩʱ䣺_________
ǩʱ䣺_________
ϵ绰_________
ϵ绰_________
Խⷿͬ 3
ⷽ_______¼Ƽ
ⷽ_______¼ҷ
ݡлͬйع涨ס˫ԸƽȡĻϣЭһ£Ϊȷ˫֮Ȩͬ
һݵ䡢
1ӵе_______еķݳҷʹá
2ⷿݽ_______ƽף÷̯
;
1Ӧҷʾ÷ݵġȨ֤÷Ȩ.֤
2ҷŵķݽΪ_______
֧ʽ
1ڣ_______
2ȨջسⷿݣҷӦڽҷ⣬ǰһ֪ͨͬǩͬ
3÷ÿΪ_______Ԫ
Կ_______װѡҵ______________ˮ_______úȻ_______ߣ_______ҵ_______
ġ
ⷽ_______
зҷ_______
֤룺_______
֤룺_______
ͥסַ_______
ͥסַ_______
绰룺_______
绰룺_______
֤_______
֤룺_______
סأַ_______
绰룺_______
˫ǩԼʱ䣺_____________________
Խⷿͬ 4
ⷽ
ⷽҷ
ϵַ
ϵַ
绰
绰
֤ţ
֤ţ
ס˫лйطɡصطԷĹ涨ںϷƽȡԸεĻǩͬŵͬء
һҵص㼰ʩ
ӵе_________е`_________¼ơ÷ݡҷʹá÷ݸʩ
1÷______________________________________________________ֹ
2ڣ˫δЭһ¾ǰԼ
֧ʽ
1÷Ϊ_________Ԫ/¡ҷеǩͬʱ֧
2ҷ֧ÿһ죬ҷ谴5%֧ɽǷʮ죬Ȩջش˳ⷿҷ밴ʵʾסսеΥԼΡ
ġ
1Ӧ֤÷ݵijⲻΥҷɷع涨֤ԼȨˡ
2ҷڸ÷ڽΥɷ漰Գⷿ;йع涨Ϊ
3δͬ⣬ҷý÷ݲֻȫתˡת⣬ȨֹͬҷеΥԼΡ
4ҷеˮѡѡȼѡʵʹõķãԼԼ
5ҷʹòʹʹ÷ݻڲʩϣҷӦʱάķãģҷиڲɿҷԭɵɼάޡ
塢Ѻ
Ϊ֤ҷʹø÷ݼʩҷӦǩͬʱ֧_________ԪΪѺ𡣴鷿ҷ÷ԿͬʱѺȫ黹ҷ
ֹͬ
1ס˫Эһ±ֹͬ
2ҷӦսԿʹ״̬Ʒ
3ס˫еһΥԼһȨֹͬԷ⳥Ҫ
ߡΥԼĴ
˫һΥԼ⳥Է_________µķ
ˡرԼ
_________
š
1ͬһʽݣס˫ִһݡ
2˫бͬʱӦЭ̽Э̲ɵĿڵԺߡ
£_________
ҷ£_________
ˣǩ֣_________
ˣǩ֣_________
_________________
_________________
Խⷿͬ 5
ⷽ____________________֤룺___________________________________
ҷⷽ____________________֤룺___________________________________
ݡлͬйطɡĹ涨˫ƽȡԸĻϣЭһ£Ϊȷ˫֮ȨϵͼϷӵеķݳҷʹãҷмˣͬ
һݵ䡢װޡʩ
1ӵ_______________________أ___________________ķݳҷʹá
2ⷿݽ__________ƽס
3÷װʩ˫ڡҵյм˵˫Լ⣬áҵյΪձͬԼҷʹúҷڱͬ÷ݵվݡ
ס˫ṩ֤
1ṩ֤֤ڱ
2ҷṩ֤ס֤֤
1÷ڹ_________¡______________________________________________________ֹ
2ҷŵ÷ݽΪ__________ʹá
3ȨջسⷿݣҷӦڽҷҪ⣬ǰһ֪ͨͬǩͬ
ġ֧ʽ
1÷ÿ__________Ԫд__________Ǫ__________ʰ_____Ԫ
2÷֧ʽΪ__________
塢
ڣ÷йظõijеʽΪ
һҷеˮ//绰/ӷ/ů/ȼ/ҵ//_________ȷá
еˮ//绰/ӷ/ů/ȼ/ҵ//_________ȷá
ʹ
1ڣӦ֤ⷿݵʹðȫҷӦʹķݼ丽ʩҷʹòɷݼʩģҷӦ뾭ò
2÷ݼʩάγ˫ڱͬԼ⣬ɼ𣨵ҷʹò⣩άǰ֪ͨҷҷӦЭϡ
3ҷʹҪڲӰ췿ݽṹǰ£ԶԷݽװװΣƹģΧաϵȷӦüͬʩڷݵװС
4ҷװװβּɵ
ߡݵתת
1ڼ䣬Ȩշתøóķݣתúͬµķ˺ҷЧ
2δͬ⣬ҷת⡢תⷿݡ
3ͬҷתⷿݵģӦЭ飬ҷӦЭתⷿݡ
ˡҷΥԼĴ涨
1ڣҷΪ֮һģȨֹͬջظ÷ݣҷӦ֧ͬ________%ΥԼ֧ΥԼֲʧ'________ҷӦ⳥ֱﵽֲȫʧΪֹ
1δͬ⣬Խת⡢תʹõġ
2δͬ⣬Բı䶯ݽṹݣҾ֪ͨڹ涨δġ
3Ըı䱾ͬ涨;ø÷ݽΥġ
4Ƿۼ_________ϵġ
2ڣҷڽˮ硢úȻʹ÷ãÿ_________죬Ӧõ________%֧ɽڴ_________ϵģȨջطݣɵһкҷге
3ڣҷδͬ⣬;ģҷӦͬ________%Ķ֧ΥԼ֧ΥԼʧģҷӦ⳥
4ҷӦڽ÷ݡҷڹ黹ÿ_________Ӧ֧ԭ_________ΥԼ
šΥԼ涨
1δͬ涨ʱ䣬ݹҷʹõģÿ_________죬Ӧ_________ҷ⸶ΥԼ_________죬ӼбͬҷȨֹиúͬӦ涨֧ΥԼ⣬ӦΥԼʵʾʧ⳥
2ڣDZͬڰ1涨Խͬǰջظ÷ݵģӦ˻ʣδʹ÷ãͬʱͬ_________%ҷ֧ΥԼ֧ΥԼֲҷʧģӦ⳥
3Ȩ覴üǷⷿݶ±ͬЧʱӦҷʵʾʧ⳥
ʮȨ
1շȨתƸʱԼ£ͬµķȨ˼Ч
2۷ݣ_________ǰ֪ͨҷͬ£ҷȹȨ
ʮһⷿע
1ҷӦڷڽ_________ڣⷿݼ豸
2ҷӦַݼʩ豸״̬ƷӰ췿ݵʹáδͬƷΪҷȨãҷ顣
3ڼ䣬ҷΪģȨͬջسⷿݣ
1δͬ⣬ת⡢תⷿݡ
2δͬ⣬Բı䶯ݽṹ
3ⷿݣڼĺδġ
4Ըı䱾ͬ涨ķ;
5óⷿݴΣƷΥ
6ڽˮ硢úȼ绰ҵãѾ
7Ƿ_________ϡ
ʮ
֮һģ˫Ա߽ͬ
1˫Эһµġ
2ɿʹܼͬеġ
3ɹ涨ֹͬġ
4ݲǨ涨ʱҪݵġ
5ԭֹͬģʵʹʱ㣬ٲ
ʮԼ
1ͬδˣס˫Эһ£ɶΪͬɷָһ֣뱾ͬͬȷЧ
2ס˫бͬ飬ӦЭ̽Э̲ʱ˫ͬطԺϡ
3ͬͬһʽ_________ݣɼס˫ִ________ݣͬȷЧ
ǩ£____________________________ҷǩ£_______________________________
ϵ绰______________________________ϵ绰_________________________________
________________________________________________________________________
Խⷿͬ 6
_________
ҷ_________
˫ҷһ£Э̴Э飬˫ִͬУ
һⷿݵλáԼ
1ͬⷿ____________
2ݵĽ___ƽסʹ___ƽס
3ⷿݵķݲȨţ_________
ڶڲװҪ豸
Ϊ____________12ʱ_________12ʱ㡣ǰ___죬ҷҪ⣬ҪṩɼǷǩͬڣݣӦǰ___֪ͨҷҷڽӵ֪ͨ___ھǷʹȹȨҷڲôΪȨ
佻ɷʽÿ___Ԫд_________½ͬǩҷӦ֧һµԺÿ__ǰҷ֧¸µ
ѺѺ___Ԫд_________ѺڱϷڵ豸ã豸Ȩг۸۳Ӧ⳥ͬҷûڵ豸Ӧںͬ˻
ɺװӦ֤ݷϺͬԼʹ;֤ˮ繩Ӧ©ˮǽȻ䡢ˮӦȶҷʹ÷ݾӰΣӦڽӵҷ֪ͨ__֮ԽҷȨǰͬȨҪ֧ΥԼҷʹùУԸı䷿ݵĽṹװΪΥԼӦ֧ΥԼ
ݳڼݣҷֲԸӦ֤ҷԼޣֱڼ
ڰΥԼ
1ڼڣҷΪȨͬջطݣȨݱЭҪҷеΥԼΡ
1Խת⡢תáתģ
2óⷿݽзǷģ
3Ƿ__¡
2ҷڽ𣬳Ӧ⣬ӦǷ֧ΥԼÿΥԼıΪǷ'__%
3ҷת⡢תáתģӦ֧___µΪΥԼ
4һкͬԼΥԼΪΥԼӦԼ⳥ΥԼɵʧ⣬Ӧ֧___ԪΥԼ
ھȳȨڼⷿݣҷͬȳȨڼҷȷʵҵݣӦһµĿڣڵķԼķһ
ʮɿΪºͬʱ˫еΡʵס㣬ٲ
ʮһķʽͬй緢飬Ӧ˫ѺЭ̣Э̲ʱڵطԺϡ
ʮͬ˫ǩ֮Чһʽݣ˫ִһݣűһݡ
ʮݲȨ֤ӡҷ˫֤ĸӡΪ֮ͬͬ
ⷽ________ⷽ________
绰________绰________
ַ________ַ________
________________________
Խⷿͬ 7
ҷ
ݡлͬйع涨Ϊȷ˫Ȩ˫Эһ£ǩͬ
һԸ⽫_________________________¥ҷ11000Ԫ/꣨дҼҼǪԪ
һһһԸ塣
1꣬________________________________ա⣬ǰ1´к
ġڼˮһзãҷ밴ʱ塣У1̨ӻ1̨̻1̨ˮ1̨һյ1̨2ţȫ£2ţȫ£1šɳ1
塢ڼ䲻һʩҪռ⳥ȡ3000ԪдǪԪѺʱݼҾҵ`£˻Ѻҷ
ڼһаȫΣȫҷи𣬼κΡҷӦݴɨɾ粻ɨҷѺп۳ѡ
ߡݣҷӦһǰ֪ͨڼ䣬ת⡣
ˡͬһʽݣ˫ִһݣͬǩ֮Ч
£_________
ҷ£_________
ˣǩ֣_________
ˣǩ֣_________
_________________
_________________
Խⷿͬ 8
ⷽ¼Ƽ____________
֤____________________________
ⷽ¼ҷ____________
֤____________________________
ݡлͬطɵĹ涨ס˫ƽȡԸĻϣзݵˣЭ飺
һݻ
1ݣ¼Ƹ÷ݣλ________________________________________ƽס
2÷װʩ豸ͬ
øΪպͬԼҷʹúҷڱͬ÷ʱݡ
ڶ;
÷;Ϊ______________________ס_________ˡ
˫Լ⣬ҷı䷿;ס
__________________________________________ֹ
ȨջسⷿҷӦڽҷҪ⣬______֮ǰ֪ͨͬǩͬ
֧ʽ
÷ÿΪ__________ԪҴд֧ʽΪ_______________ÿ֧ڿʼǰ________֧
Ѻ
ס˫Աͬǩ֮ҷ֧Ѻ__________ԪҴд______________ݾպϸȫ˻ҷ
ӦڱͬЧ֮__________ڣ÷ݽҷ
ڷڼйط
1ڷڼ䣬·ɼ֧____________________________
2ҷӦʱ·ãúˮ__________________________
ڰݵʹ
1ڣķݴɼеճķάҳе
2ҷӦʹķݼʩҷʹòɷݼ豸'ʧάãҷеβ⳥ʧ
3ڼ䣬ȫۺȫȹҷӦִейزŹ涨еȫκͷӼල顣
ھݽջص
1ʱ˫Ӧͬ룬װޡӲʩ豸Ӧ
2ҷӦڷⷿݼʩ豸
3ҷʱƷӰ췿ݵʹãδͬƷȨá
ʮͬı
1˫Эһ£Խͬ
2һ֧Է൱_______·ģҲԽͬҷŵģ˻Ѻ
ʮһΥԼ
ڼ䣬ҷΪ֮һģȨֹͬ
1δͬ⣬ݷ⡢ת⡢תʹõġ
2δͬ⣬Ķݽṹݵġ
3ı䱾ͬ涨;סø÷ݽΥġ
4Ƿⳬ__________ա
5δʱɱͬӦɷó_____________Ԫ_____յġԭֹͬģҷɵѺ˻ʧģӦеӦ⳥Ρ
ʮ
1ɿԭ¸÷ݻʧģ˫еΡ
2ɿϵָԤܱⲢܿ˷Ŀ
3ԭֹͬģʵʹʱ㣬µİ_______㣬ٲ
ʮЭ
ͬδɼס˫鶨ǩЭ顣Э뱾ͬһµģԲЭΪ
ʮ
ͬз飬ɼס˫Э̽Э̲ʱס˫йϽȨߡ
ʮ
ǰˮȱ״
1ˮΪ_____________
2Ϊ_____________
3úΪ___________
ʮͬԼס˫ǩ֮Чһʽ_______ݣס˫ִ_______ݣͬЧ
ǩ£______________
ҷǩ£_________________
ϵʽ__________________
ϵʽ______________________
_______________________
_________________________
Խⷿͬ 9
ⷽ(¼Ƽ)________________________
ⷽ(¼ҷ)________________________
ݡлͬйطɡ涨ԸƽȡĻϣͼϷӵеķݳҷʹãҷʹü˶ͬ
һ
1Ϸӵеڵķ______ҷھӪķݽ_______________ƽסʹʣ____________(סլӪ÷ѡһ)
;
3ҷΪ________________________________˾סʹá
4ҷŵڣδüͬ⣬ҷԸı䷿ݵԭнṹ;
5ͬΪ____________ֹ
ġ֧ʽ
6Ϊÿ____________Ԫңÿ___________ǰ֧֧ʽ_____________
塢Ȩ
7Ӧҷ֧____֮սԿҷ
8뱣֤ҷķܹ¾Ӫýҷõķת()κεߣڷӼۡ
9ڼ䣬öķݼڷΧڵʹȨ趨Ѻ֤ⷿȨʹ֮ס
10ҷΪģȨջطݡҷõھӪпƶ豸ʩҷУδƶ豸СҷӦ15ڰ롣
ҷȨ
11ҷձͬԼʹ÷ݣеȻĵ⳥Ρ
12ҷڲƻԭṹ`ϣȨݾӪҪݽװޣø档
13ڣˮ硢ѡҵѡծҷге
14ձЭԼ֧
ߡʹҪά
15ڼ䣬ҷָ÷ݼ丽ʩʱӦʱ֪ͨӦڽӵҷ֪ͨ____ڽάޡڲάģҷɴΪάɼе
16ҷӦʹòݼ丽ʩҷʹòʹãʹ÷ݼ丽ʩϵģҷӦҷܲάޣ˿ɴΪάޣҷе
17ڼ䣬ҪԸ÷ݽиĽװģи֪ҷ˿ɼס˫̶
18ҷװݻ踽ʩ豸ģ֪ͨ
ˡ
19ͬδˣס˫ԲЭķʽԼЭʱͬɷָ.֣뱾ͬͬȷЧ
20ͬ˫ǩ֮Ч
ⷿ()ⷽ(ҷ)
ϵַϵַ
绰绰
֤ţ֤ţ
Ȩ֤ţ
ǩԼڣ
ǩԼڣ
Խⷿͬ 10
ⷽ_______________________
ⷽ_______________________ҷ
ݡлͬйطɷ棬˫ƽԸĻϣͼϷӵеԺӳҷʹãҷʹüǩͬ
һ
1λ__________'Ԫ¥ҷʹá
2Ϊ__________յ______ֹ
3ڼ䣬ҷδͬ⣬ýתı;ͬʱҷҪʱݹ黹ҷҪ⣬ͬҷȨһǰ֪ͬǩͬ
ѺԼ֧ʽ
1סլܶΪ______Ԫ
2֧ʽҷֽ֧ѺǩͬʱҷһԸзá
3ҷ____ѺϢδʱȨջش˷ݡ
ҷ밴ʱѺδʱȨջظ÷ݡ
ġڲת⡣
塢ͬڣˮ磬ҵůõȰҷеزŽɣͬʱҷӦԾزŵĹ涨ΥزŵĹ취ˮʩ⣬Эһзþҷ
ڼҷӦʩˮůŴˮΧʧҷӦһ⳥
ߡڼ䣬ʽͬĽҪջطݣǰһ绰֪ͨҷȡҷͬ⣬ҷ˻Ҳǰһ֪ͨȡüͬ⣬ҷΥԼѺ𣬲ҷ⳥ʧ
ˡҷӦṩй֤ԭ鿴ӡͬзףӦͨ˫Э̽Э̲ɣԺ
šͬδˣɾ˫Э涨涨뱾ͬͬȷЧͬһʽݣɼ˫ִһݣ˫ǩЧ
ǩ_______ҷǩ_______
֤ţ_______֤ţ_______
ϵ绰_______ϵ绰_______
ͥסַ_______ͥסַ_______
ǩԼڣ_______ǩԼڣ_______
Խⷿͬ 11
ⷽ___________________֤룺__________________
ҷⷽ___________________֤룺__________________
ס˫ͷˣЭ飺
1λ___________________________________С_________¥_________Ԫ_________ҵķݵҷסʹã⣩__________________________________________գ_______
2䷿Ϊ_______Ԫ_______//꣩ÿ_______//꣩3ڣҷ֧ȫ_______//꣩_______Ԫ
3ҷڼ䣬ˮѡѡȼԼҷסķҷȫʱйز֧ˮȸⷿʹôʱҷ뽻Ƿѣ֪ͨûнַãѡˮѵȣ뿪ȨйܲűʱҷҪ֪ͨ˫赱鷿ṩƷͷ谴ر⳥
4ҷͬԤ_______ԪΪ֤𣬺ֹͬʱ
5䷿Ϊ__________________________________________ڴڼ䣬κһҪֹͬǰ֪ͨԷԷһµ'ΥԼ
6ڳڼ䣬δͬ⣬ҷȨתת÷ݣøı䷿ݽṹ;ҷΪԭɸ÷ݼʩģҷе⳥ҷⷿڼ䣬Һը©ϵ©Ȱȫ¹ʣҷгеȫ
7֤÷ȨףṩӦıر豸ڷѰʱɵǰ£ɼҵ
8ͱͬף˫Э̽Э̲ɣκһȨйزϣ˾
9ͬһʽ2ݣס˫ִ1ݣ˫ǩ֮Ч
ǩ֣_______________ҷǩ֣________________
ϵ绰___________________ϵ绰_____________________
__________________________________________________
Խⷿͬ 12
ⷽ________֤룺___________________
ⷽҷ________֤룺___________________
˫˫Эһ£ǩ顣
һޱ
вȨȨίޣ___________________Ϊ____________ƽķݣҷڰ칫Ӫҵ
ڶ
ԼΪ____꣬ȣ________________________ֹ
𡢷ýɷʽ
1ԼݵΪÿ________ԪңԼÿƽ________Ԫ/죩ҷ____ʽ֧_______ṩ˰϶ʽƱ
2ÿ________ΪһڽһΣҷ________________ǰһ____ʽ֧ˮѡҷʵʷ涨ʱɸйزţǷ
3ڼҵ____е
4˰ҷ˰ŵع涨е
5ҷе˫ͬеķ⣬뱾йص˰Ѿɼе
Լ
1ӦṩԼݵIJȨ֤ʹȨ֤ӡƽͼͷϸ֤ӡҷΪĸ
2ӦҷزŵĹ涨ڳⷿװʹҡҵʶͬҵװҵҪʩṩ㣬ͷҷаͳе
3˫ŵ˫ʽǩ𡶷ͬӦ____________ǰݽҷݴ____________տʼ
ӳٽݿʼ.Ӧ˳ӡŵװΪ____죬ڸ÷ݲҵѡˮܺķѵҷге
Ϊ˫
ӳ˫ⶩġ顷ΪԼ˫Ϊķļ߷Ч죬˫ʽǩͬ뱾㣣ԡͬΪ
һʽݼҷִһݡ
ǩ£___________ҷǩ£_______________
ǩڣ_________________________________
Խⷿͬ 13
ⷽ_______
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˫ƽȡԸĻϣкЭ̣Э飺
һⷿص㣺ͬҵķoҷ֤÷ĺϷԡ
;ҷⷿݽΪãýκΥԸ
ڣ________________________________ֹҷڽݹؼ
ġÿ____Ԫ
塢ⷿѺ𣺱κ֧ͬѺ𣬰ϴεЭ֧ǪʰԪ2250BֹⷿƾߵѺվݣϴεķǪʰԪ2250B˻ҷϢ
ʽҷÿ֧һΣ֧B
ߡ
1뱣֤÷ݵĽṹʩʹá
2άɼ
3ڲõṩ𣬷ΥԼ
ˡҷ
1ձͬ涨ʱͷʽ֧
2δͬ⣬ҷ˽Ѹ÷IJֻȫתˡ
3ֹͬʱṩ'ʩ㡢ƽȱӦֵ⳥
4ҷʹòݼʩģӦԭ״Ծ⳥ˮ硢úʹò¹ʣ____ء
šΥԼ
1ҷΥͬڰȨֹͬջطݣûʣ粻ֹʧҷӦ⳥
2ΥͬҷȨֹͬӦһҷ֧ΥԼ𣬲˻ʣⷿѺ
3ҷǷ;˷谴һ֧ΥԼ𣬼˻ʣѺ𣬷ûʣ⼰֤
4ҷѳҷȲǩͬҲ˷Ը÷ȨҷԸ
ʮԼ֮ǰһ¡
ʮһͬδˣһɰաл䡷йع涨˫Э˲涨涨뱾ͬͬȷЧ
ʮˮ𡢻֡Ǩͷɷ桢߱仯Ȳɿԭ±Э鲻ȫУס˫еΥԼΣʵʱ㣬ٲ
ʮͬһʽݣס˫ִһݣÿݾͬȷЧӦ
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Խⷿͬ 14
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˫Э꣬________________________ΪֹԤԪʣɸɼʹá
˫ЭΪ_____________ԪŵЭڼ䲻ٱ
ġҷúӦע
1ҷӦطϷⷿаеΡ
2ҷӦעסȫвȡ𡢷Ȱȫʩǿõ簲ȫϡҽӵߣڷõ簲ȫо顣ҷʩɵʧʧҷгеɼݲƲʧҷȫ⳥ɵݲƲʧҷҷȫ⳥ԷΥԼ
3ҷ÷ûдȨ˺⡢תˣҲܸı;ΥԼд֧ΥԼ⣬ȨЭ鲢ջطݡǰҷṩˮ硣ڼ䣬ҷĵ硢ˮȷҷʱɣʧ鷳ҷнȷЭʱҷӦ֧Ҫá
Ͻɷվҷб棬Աԡ
___________ˮ_________________________ҷк˶ԣд
4ҷڣøı䷿ݽṹʩʹܵӦͨ
5ҷװı䷿ݰȫṹҷǰջطʱ밴װ۳ֵҷδɵʧ(ҷṩӦ֤)
塢δˣ
1Эڣҷκ⡢תáҷΥԼԭɼǰջطݵһ£ҷ밴Э嵱ˮѵӦ
4ҷӦù黹ⷿЭԿйƷⷿڵ豸ҷеӦ⳥
5Эҷ⣬ͬǩµ`ⷿЭ顣
Э龭ҸЭһ¡ͬ⡢ǩºЧǩ֮ΪЭЧڣ
עЭҼʽݣҸִҼݡ
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Խⷿͬ 15
ⷽ¼Ƽ_____________֤ţ_____________________________
ⷽ¼ҷ_____________֤ţ_____________________________
ס˫ͷˣЭ飺
һλ________________________________________________ķݵҷסʹã⣩__________________________________________գ_______¡
䷿Ϊ_______Ԫ_______//꣩㡣ÿ_______//꣩3ڣҷ֧ȫ_______//꣩_______Ԫ
ҷڼ䣬ˮѡѡȼԼҷסķҷȫʱйز֧ˮȸⷿʹôѡʱҷ뽻Ƿѣ֪ͨûнַãѡˮѵȣ뿪ȨйܲűߡʱҷҪ֪ͨ˫赱鷿ṩƷͷ谴ر⳥
ġҷͬԤ_______ԪΪ֤𣬺ֹͬʱ֡
塢䷿Ϊ__________________________________________աڴڼ䣬κһҪֹͬǰ֪ͨԷԷһµΥԼ
ڳڼ䣬δͬ⣬ҷȨתת÷ݣøı䷿ݽṹ;ҷΪԭɸ÷ݼʩ`ҷе⳥Ρҷⷿڼ䣬Һը©ϵ©Ȱȫ¹ʣҷгеȫΡ
ߡ֤÷ȨףṩӦıر豸ڷѰʱɵǰ£ɼҵѡ
ˡͱͬף˫Э̽Э̲ɣκһȨйزϣ˾
šͬһʽ______ݣס˫ִ______ݣ˫ǩ֮Ч
ǩ£__________________
ҷǩ£__________________
绰___________________________
绰___________________________
_________________________
_________________________
Խⷿͬ£
Խⷿͬ08-08
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