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医疗费报销单</strong></span><span style="font-size: 26px"><strong><span style="font-size: 12px"><br />
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</span>{DATA_52}&#160;
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<table class="xdLayout" tabindex="65535" border="1" bordercolor="#ffffff" style="border-bottom: medium none; border-left: medium none; width: 648px; border-collapse: collapse; word-wrap: break-word; table-layout: fixed; border-top: medium none; border-right: medium none">
    <colgroup><col style="width: 88px" /><col style="width: 151px" /><col style="width: 60px" /><col style="width: 69px" /><col style="width: 60px" /><col style="width: 65px" /><col style="width: 61px" /><col style="width: 69px" /><col style="width: 25px" /></colgroup>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: #000000 1.5pt solid; border-top: #000000 1.5pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">职工姓名</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: #000000 1.5pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_53}</font></div>
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            <td valign="middle" colspan="2" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: #000000 1.5pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">工 作 部 门</font></div>
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            <td valign="middle" colspan="4" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: #000000 1.5pt solid; border-right: #000000 1.5pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_54}</font></div>
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            <td valign="middle" rowspan="4" style="border-bottom: #000000 1pt; border-left: #000000 1.5pt solid; border-top: #000000 1pt; border-right: #000000 1pt">
            <div style="line-height: 1.5" align="left"><font face="宋体">附据单{DATA_55}张</font></div>
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        <tr style="min-height: 56px">
            <td valign="middle" style="border-bottom: black 1pt solid; border-left: #000000 1.5pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">家属姓名</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_56}</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">性 别</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_57}</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">年 龄</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_58}</font></div>
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            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">与职工</font></div>
            <div style="line-height: 1.5" align="center"><font size="3">关 系</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: #000000 1.5pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_59}</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: #000000 1.5pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">单据中应</font></div>
            <div style="line-height: 1.5" align="center"><font size="3">报销金额</font></div>
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            <td valign="middle" colspan="2" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">￥{DATA_60}</font></div>
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            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">应 报 销</font></div>
            <div style="line-height: 1.5" align="center"><font size="3">比 例(%)</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_61}</font></div>
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            <td valign="middle" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">实报销</font></div>
            <div style="line-height: 1.5" align="center"><font size="3">金 额</font></div>
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            <td valign="middle" colspan="2" style="border-bottom: black 1pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: #000000 1.5pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_62}</font></div>
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        <tr style="min-height: 56px">
            <td valign="middle" colspan="3" style="border-bottom: #000000 1.5pt solid; border-left: #000000 1.5pt solid; border-top: black 1pt solid; border-right: black 1pt solid">
            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">实 报 销 金 额 人 民 币（大写）</font></div>
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            <td bgcolor="transparent" valign="middle" colspan="5" style="border-bottom: #000000 1.5pt solid; border-left: black 1pt solid; border-top: black 1pt solid; border-right: #000000 1.5pt solid">
            <div style="line-height: 1.5" align="left"><font size="3" face="宋体">{DATA_63}</font></div>
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            <div style="line-height: 1.5" align="center"><font size="3" face="宋体">审批人:{DATA_64} 复核:{DATA_65} 出纳:{DATA_66} 领款人:{DATA_67}</font></div>
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            <div style="line-height: 1.5" align="center">&#160;</div>
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