申请核定表

登记编号：X北京市家庭购买限价商品住房申请核定表申请人姓名：身份证件编号：户籍所在地：区（县）街道（乡镇）居委会街（胡同、小区、村）号(楼) 单元室现居住地址：区（县）街道（乡镇）居委会街（胡同、小区、村）号(楼) 单元室通讯地址：邮编：移动电话：固定电话：申请家庭成员情况申请人及共同申请家庭成员与申请人关系姓名性别婚姻状况身份证件编号户口所在地户籍性质工作学习单位申请人申请人取得本市户籍时间年月日取得本市户籍年说明：1.“申请人及共同申请家庭成员”申请家庭成员之间应具有法定的赡养、扶养或者抚养关系，包括申请人及其配偶、子女、父母等。

2.“与申请人关系”栏填写：之妻、之夫、之子、之女、之父、之母等。

3.“婚姻状况”栏填写：未婚、已婚、离婚、丧偶等。

4.“身份证件编号”栏填写：经公安机关进行升位处理后的18位身份证号（以户口簿为准）。

5.“户口所在地”栏填写：户口薄首页户口登记住址。

6.“户籍性质”栏填写：非农业农业7.“工作学习单位”栏填写：工作学习单位全称，没有的填“无”。

申请家庭住房情况第一处房屋坐落使用面积m2产权人（单位）承租人房屋类型□成套楼房□简易楼房□平房是否拆迁□是□否居住情况□直管公房□自管公房□已购公房□城镇私房□商品住房□宅基地建房□市场租住房□集体土地住房□经济适用住房□廉租住房实物房□其他第二处房屋坐落使用面积m2产权人（单位）承租人房屋类型□成套楼房□简易楼房□平房是否拆迁□是□否居住情况□直管公房□自管公房□已购公房□军产公寓房□城镇私房□商品住房□宅基地建房□市场租住房□集体土地住房□经济适用住房□廉租住房实物房□其他个人产权房屋所有权证编号第一处房房权证字第号第二处房房权证字第号共居人口人住房使用面积m2人均住房使用面积m2有无自建住房□无□有间 m2说明：1.申请家庭有多处住房应分别填写。

2.“房屋坐落”栏填写：有住房的填写房屋地址，无住房的填写现居住地址。

原住房已拆迁的，请填写被拆迁住房地址。

医疗机构名称申请核定表范文英文回答：Medical Institution Name Application and Approval Form.1. Name of the Medical Institution: [Insert Name]2. Type of Medical Institution: [Insert Type] (e.g., hospital, clinic, diagnostic center)。

3. Location of the Medical Institution: [Insert Address]4. Contact Information:Phone Number: [Insert Phone Number]Email Address: [Insert Email Address]5. Purpose of the Medical Institution:The purpose of the medical institution is to provide quality healthcare services to the community. We aim to offer comprehensive medical care, including diagnosis, treatment, and prevention of diseases.6. Target Population:Our medical institution aims to serve the entire community, regardless of age, gender, or socio-economic background. We strive to provide accessible and affordable healthcare services to all individuals in need.7. Medical Specialties Offered:Our medical institution offers a wide range of medical specialties, including but not limited to:Internal Medicine.Pediatrics.Obstetrics and Gynecology.Surgery.Orthopedics.Cardiology.Dermatology.Neurology.8. Facilities and Equipment:Our medical institution is equipped with state-of-the-art facilities and medical equipment to ensure accurate diagnosis and effective treatment. We have modern operation theaters, diagnostic laboratories, imaging centers, and emergency care units.9. Medical Staff:Our medical institution boasts a team of highlyqualified and experienced medical professionals, including doctors, nurses, technicians, and support staff. All our staff members are committed to providing excellent medical care and ensuring patient satisfaction.10. Legal and Regulatory Compliance:We understand the importance of complying with all legal and regulatory requirements in the healthcare industry. Our medical institution adheres to all applicable laws, regulations, and standards to ensure patient safety and confidentiality.11. Conclusion:We believe that our medical institution, with its dedicated staff, advanced facilities, and comprehensive medical services, will make a significant contribution to the healthcare sector. We are committed to promoting health and well-being in our community.中文回答：医疗机构名称申请核定表。

（医疗机构名称核定通知通知函存根）一、提交的材料1、核定营利性医疗机构需提交工商行政部门出具的《企业名称预先核准通知书》复印件1份；2、核定非营利性医疗机构不需要提交其他材料。

二、名称核定要求医疗机构名称应符合《医疗机构管理条例实施细则》的相关要求：第四十条医疗机构的名称由识别名称和通用名称依次组成。

医疗机构的通用名称为:医院、中心卫生院、卫生院、疗养院、妇幼保健院、门诊部、诊所、卫生所、卫生站、卫生室、医务室、卫生保健所、急救中心、急救站、临床检验中心、防治院、防治所、防治站、护理院、护理站、中心以及卫生部规定或者认可的其他名称。

医疗机构可以下列名称作为识别名称:地名、单位名称、个人姓名、医学学科名称、医学专业和专科名称、诊疗科目名称和核准机关批准使用的名称。

第四十一条医疗机构的命名必须符合以下原则:(一)医疗机构的通用名称以前条第二款所列的名称为限:(二)前条第三款所列的医疗机构的识别名称可以合并使用:(三)名称必须名符其实:(四)名称必须与医疗机构类别或者诊疗科目相适应:(五)各级地方人民政府设置的医疗机构的识别名称中应当含有省、市、县、区、街道、乡、镇、村等行政区划名称,其他医疗机构的识别名称中不得含有行政区划名称:(六)国家机关、企业和事业单位、社会团体或者个人设置的医疗机构的名称中应当含有设雷单位名称或者个人的姓名。

第四十二条医疗机构不得使用下列名称:(一)有损于国家、社会或者公共利益的名称:(二)侵犯他人利益的名称:(三)以外文字母、汉语拼音组成的名称:(四)以医疗仪器、药品、医用产品命名的名称:(五)含有“疑难病”、“专治”、“专家”“名医”或者同类含义文字的名称以及其他宣传或者暗示诊疗效果的名称: (六)超出登记的诊疗科目范围的名称:(七)省级以上卫生行政部门规定不得使用的名称。

第四十五条除专科疾病防治机构以外,医疗机构不得以具体疾病名称作为识别名称,确有需要的由省、自治区、直辖市卫生行政部门核准。

医疗机构名称申请核定表范文英文回答：Medical Institution Name Application and Approval Form.1. Name of the Medical Institution: [Enter the proposed name of the medical institution]2. Type of Medical Institution: [Select the appropriate type from the options provided, such as hospital, clinic, nursing home, etc.]3. Location of the Medical Institution: [Provide the complete address where the medical institution will be located]4. Contact Information:Name of Contact Person: [Enter the name of the primary contact person]Phone Number: [Provide the contact person's phone number]Email Address: [Provide the contact person's email address]5. Purpose and Scope of the Medical Institution: [Briefly describe the purpose and scope of services that the medical institution will provide. For example, if it is a hospital, mention the types of departments and medical specialties it will have.]6. Legal Structure of the Medical Institution: [Specify the legal structure of the medical institution, such as whether it is a private entity, government-owned, or a non-profit organization.]7. Ownership and Management: [Provide details about the ownership and management structure of the medical institution. Include information about the owners or shareholders, as well as the top-level management team.]8. Human Resources: [Provide an overview of the human resources available or planned for the medical institution, including the number of doctors, nurses, and other healthcare professionals.]9. Facilities and Equipment: [Describe the facilities and equipment that will be available at the medical institution. Include information about the size of the premises, the number of beds (if applicable), and any specialized equipment or technology.]10. Financial Resources: [Provide information about the financial resources available to establish and sustain the medical institution. Include details about the initial investment, sources of funding, and projected revenue streams.]11. Timeline for Establishment: [Outline the timeline for the establishment of the medical institution, including key milestones and target completion dates.]12. Any Additional Information: [If there is any additional information that you would like to provide to support the application, mention it here.]中文回答：医疗机构名称申请核定表。