<link rel="stylesheet" type="text/css" href="/static/theme/workflow/5/style/css/style.css" />
<link rel="stylesheet" type="text/css" href="/static/theme/workflow/5/jqtransformplugin/transform.css" media="all" />
<div class="container">
<div class="form_body"><!--{13427533287940}-->
<div class="head_er line" style="text-align: left; padding-top: 15px; padding-left: 20px; display: inline">事故登记表
<div class="tbrq" style="font-size: 12px; margin-left: 250px; display: inline; background-color: #7e97ad">填表日期：{DATA_2}</div>
</div>
<!--{13427533287941}-->
<div class="form_body_1">
<div class="cent_er"><!--{13427533287942}--><!-- 表单元素分组线 -->
<div class="form_row">
<div class="text_li" style="height: 28px; margin-top: 10px; width: 70px"><span class="text_gray">姓名</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_6}</span></span></div>
<div class="text_li" style="height: 28px; margin-left: 40px; margin-top: 10px; width: 70px"><span class="text_gray">性别</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_7}</span></span></div>
</div>
<!-- 表单元素分组线 -->
<div class="form_row">
<div class="text_li" style="height: 28px; margin-top: 10px; width: 70px"><span class="text_gray">年龄</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_8}</span></span></div>
<div class="text_li" style="height: 28px; margin-left: 40px; margin-top: 10px; width: 70px"><span class="text_gray">职位</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_9}</span></span></div>
</div>
<!-- 表单元素分组线 -->
<div class="form_row">
<div class="text_li" style="height: 28px; margin-top: 10px; width: 70px"><span class="text_gray">身份证件</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_10}</span></span></div>
<div class="text_li" style="height: 28px; margin-left: 40px; margin-top: 10px; width: 70px"><span class="text_gray">个人保险</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_11}</span></span></div>
</div>
<!-- 表单元素分组线 -->
<div class="form_row">
<div class="text_li" style="height: 28px; margin-top: 10px; width: 70px"><span class="text_gray">所属部门</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_12}</span></span></div>
<div class="text_li" style="height: 28px; margin-left: 40px; margin-top: 10px; width: 70px"><span class="text_gray">入职时间</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_13}{OTHER_1}</span></span></div>
</div>
<!-- 表单元素分组线 -->
<div class="form_row">
<div class="text_li" style="height: 28px; margin-top: 10px; width: 70px"><span class="text_gray">事故类型</span></div>
<div style="margin-top: 20px; width: 547px"><span class="text_stlye1" style="width: 547px"><span class="text_stlye11" style="width: 547px">{DATA_14}</span></span></div>
</div>
<!-- 表单元素分组线 -->
<div class="form_row">
<div class="text_li" style="height: 28px; margin-top: 10px; width: 70px"><span class="text_gray">发生时间</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_15}{OTHER_2}</span></span></div>
<div class="text_li" style="height: 28px; margin-left: 40px; margin-top: 10px; width: 70px"><span class="text_gray">发生地点</span></div>
<div style="float: left; margin-top: 20px; width: 216px"><span class="text_stlye1" style="width: 216px"><span class="text_stlye11" style="width: 216px">{DATA_16}</span></span></div>
</div>
<!-- 表单元素分组线 -->
<div class="text_li" style="margin-top: 10px; width: 630px"><span class="textarea_gray" style="margin-top: 0px; width: 100px">事故情况</span>
<div class="textarea_6" style="width: 623px">
<div class="textarea_top">
<div class="textarea_61">&#160;</div>
<div class="textarea_62">&#160;</div>
</div>
<div class="textarea_a">{DATA_17}</div>
<div class="textarea_bottom">
<div class="textarea_63">&#160;</div>
<div class="textarea_64">&#160;</div>
</div>
</div>
</div>
<!-- 表单元素分组线 -->
<div class="text_li" style="margin-top: 10px; width: 630px"><span class="textarea_gray" style="margin-top: 0px; width: 100px">事故医疗单</span>
<div class="textarea_6" style="width: 623px">
<div class="textarea_top">
<div class="textarea_61">&#160;</div>
<div class="textarea_62">&#160;</div>
</div>
<div class="textarea_a">{DATA_18}</div>
<div class="textarea_bottom">
<div class="textarea_63">&#160;</div>
<div class="textarea_64">&#160;</div>
</div>
</div>
</div>
<!-- 表单元素分组线 -->
<div class="form_row">
<div class="text_li" style="width: 305px"><span class="text_gray" style="width: 200px">员工签署</span>
<div class="input_text" style="width: 305px"><span class="text_stlye1" style="width: 285px"><span class="text_stlye11" style="width: 285px">{DATA_19}</span></span></div>
</div>
<div class="text_li" style="width: 312px"><span class="text_gray" style="width: 200px">部门经理或（主管）签署</span>
<div class="input_text" style="width: 312px"><span class="text_stlye1" style="width: 312px"><span class="text_stlye11" style="width: 312px">{DATA_20}</span></span></div>
</div>
</div>
<!-- 表单元素分组线 -->
<div class="form_row">
<div class="text_li" style="width: 305px"><span class="text_gray" style="width: 200px">人事部签署</span>
<div class="input_text" style="width: 305px"><span class="text_stlye1" style="width: 285px"><span class="text_stlye11" style="width: 285px">{DATA_21}</span></span></div>
</div>
<div class="text_li" style="width: 312px"><span class="text_gray" style="width: 200px">总经理签署</span>
<div class="input_text" style="width: 312px"><span class="text_stlye1" style="width: 312px"><span class="text_stlye11" style="width: 312px">{DATA_22}</span></span></div>
</div>
</div>
<div style="height: 15px">&#160;</div>
</div>
</div>
</div>
</div>