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["                 縣市醫療院所及照護機構MMR、Tdap及水痘疫苗採購需求調查名冊"]
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[null,"名稱","含括科別(請明列)","負責人","聯絡電話","地址","MMR數量","Tdap數量","水痘數量"]
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["填表人(簽名/核章)：",{"$nulls":4},"單位主管(簽名/核章)："]

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