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["医用耗材遴选市场调研报名表"]
["公司名称：                                                                     ",{"$nulls":3},"代理商联系人及联系方式：",{"$nulls":3},"生产厂家联系人及联系方式："]
["遴选序号","产品名称","注册证名称","注册证号","规格型号","单位","单价（以最小单位报价）","生产厂家","品牌","国家医保编码\n（27位）","在用医院全称(标注医院等级)需与所提供发票一致","备注"]
[{"$nulls":10},"1、医院全称（级别）  \n2、医院全称（级别）  \n3、医院全称（级别）……"]
["注：","同一耗材，如涉及多种规格型号，需逐行填写规格型号及医保编码"]