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["附件5"]
["中医医院中药制剂能力建设项目基本情况汇总表"]
["省份：                  联系人：                      联系电话：                        传真："]
["医院名称","医院类别","项目负责人","联系电话","医院基本情况"]
[{"$nulls":4},"级别","人员总数","床位数（张）","年门急诊人次","年出院人数","门诊中医治疗率","病床使用率（%）","病床周转次数","住院中医治疗率","年业务收入","年药品收入"]
[]
[]
[]
[]
[]
[]
["医院名称","医院基本情况",null,null,"制剂室基本情况"]
[null,"中药制剂比例","中药饮片比例","中成药比例","制剂室建立时间","人员数","制剂室面积（m2）","有无《医疗机构制剂许可证》及取得时间","设备总值 ","所有经过批准的制剂品种数","在有效期内的制剂品种数（种）","是否建立药检室","是否建立库房","经费投入","拟配套资金数"]
[]
[]
[]
[]
[]
[]
["中医医院中药制剂能力建设项目基本情况表（续）"]
["医院名称","制剂室负责人情况",{"$nulls":3},"药检室负责人情况",{"$nulls":5},"人员结构"]
[null,"年龄","学历","职称","专业","年龄",null,null,"学历","职称","专业","本科及以上学历人数",null,"大专人数","中专及以下人数"]
[]
[]
[]
[]
[]
[]
["医院名称","人员结构",null,null,"所有经过批准的制剂剂型种类",null,"所有经过批准的外用制剂品种数"]
[null,"高级职称人数","中级职称人数","初级职称人数"]
[]
[]
[]
[]
[]
[]
["注：此表由省级中医药管理部门填写"]