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["教学仪器设备维修申请表"]
["学院：（盖章）             实验室：                     年   月   日"]
["设备名称",{"$nulls":3},"规格型号"]
["供应厂商",{"$nulls":3},"设备原值"]
["申 请 人",{"$nulls":3},"联系电话"]
["故障现象"]
["专业学院意见"]
["教务处审批意见"]
["鉴定小组\n评估意见",null,null,"\n\n\n签名：",null,null,"评估\n维修\n金额"]
["维\n修\n记\n录","维修内容"]
[null,"项目内容",null,"配件名称","型号规格","数量","单价（元）","金额（元）"]
[null,"配\n件\n费",1]
[null,null,2]
[null,null,3]
[null,null,4]
[null,null,5]
[null,"人工费",null,"□台、 □件、 □天、 □时"]
[null,"合计费用",null,"￥____万____仟____佰____拾____元____角____分"]
[null,"维修单位",null,"（盖章）                             维修人员："]
["议价人员签字"]
["验     收",null,null," 1.设备维修后　　□正常使用 ",null,null,"验  收\n签  名","           年   月   日    "]
[{"$nulls":3}," 2.维修所换配件　□已回收  □未回收"]
[{"$nulls":3}," 3.以上合计费用　□较合理  □过高",null,null,"负责人\n签  名"," 年   月   日"]
[{"$nulls":3}," 4.维修服务质量　□较满意  □一般"]
["说明：本表报修的仪器设备应是已过保修期，未过保修期不必填写此表，可自行联系供应商免费维修"]

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