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山东省药品经营许可证（批发）申办程序

发布时间: 　作者: 张丽丽

鲁药监发［2004］16号 各市药品监督管理局： 
        《山东省药品经营许可证（批发）申办程序》于2004年3月29日经山东省药品监督管理局局务会议审议通过，现予发布。本程序自2004年4月1日起施行。 
     二〇〇四年三月三十一日 
            山东省药品经营许可证（批发）申办程序 
    第一条 为规范药品批发企业的申办，根据《中华人民共和国药品管理法》（以下简称《药品管理法》）、《中华人民共和国药品管理法实施条例》（以下简称《实施条例》）及《药品经营许可证管理办法》，制定本程序。 
    第二条 本程序所指药品批发企业包括药品批发法人企业、药品批发非法人企业和从事药品配送的企业。 
    第三条 开办药品批发企业应符合以下设置标准： 
    （一）具有保证所经营药品质量的规章制度； 
    （二）企业、企业法定代表人或企业负责人、质量管理负责人无《药品管理法》第76条、第83条规定的情形； 
    （三）具有与经营规模相适应的一定数量的执业药师。质量管理负责人具有大学以上学历，且必须是执业药师； 
    （四）具有能够保证药品储存质量要求的、与其经营品种和规模相适应的常温库、阴凉库、冷库。仓库中具有适合药品储存的专用货架和实现药品入库、传送、分检、上架、出库现代物流系统的装置和设备； 
    （五）具有独立的计算机管理信息系统，能覆盖企业内药品的购进、储存、销售以及经营和质量控制的全过程；能全面记录企业经营管理及实施《药品经营质量管理规范》方面的信息；符合《药品经营质量管理规范》对药品经营各环节的要求，并具有可以实现接受当地药品监督管理部门监管的条件； 
    （六）具有符合《药品经营质量管理规范》对药品营业场所及辅助、办公用房以及仓库管理、仓库内药品质量安全保障和进出库、在库储存与养护方面的条件。 
    国家对经营麻醉药品、精神药品、医疗用毒性药品、预防性生物制品另有规定的，从其规定。 
    第四条 申办人填写《药品经营许可证（批发）申请书》（式样见附件一），并提交以下材料报拟办企业所在地市级药品监督管理部门： 
    （一）拟办企业法定代表人、企业负责人、质量负责人学历、职称证明原件、复印件及个人简历； 
    （二）拟办企业法定代表人或企业负责人、质量管理负责人有无《药品管理法》第76条、83条规定情形的说明文件； 
    （三）执业药师（含执业中药师）执业证书原件、复印件； 
    （四）工商行政管理部门预先核准的拟办企业名称证明文件； 
    （五）拟设营业场所、仓库平面布局图及周边卫生环境情况。 
    以上材料一式两份，统一使用A4纸装订成册（下同）。 
    第五条 申办人所在地市级药品监督管理部门依据药品批发企业设置标准，对申办人提交的申报材料的真实性和合法性进行初审，填写《申办药品经营许可证材料审查转呈单》（式样见附件二），应当在5个工作日内报省药品监督管理部门。 
    第六条 省药品监督管理部门收到申报材料及《申办药品经营许可证材料初审转呈单》后，根据下列情况分别作出处理： 
    （一）申请材料存在可以当场更正的错误的，允许申办人当场更正； 
    （二）申请材料不齐或者不符合法定形式的，当场或在5个工作日内发给《申办药品经营许可证补正材料通知书》（式样见附件三），一次性告知需要补正的全部内容，逾期不告知的，自收到材料之日起即为受理； 
    （三）申请材料齐全、符合法定形式，或者申办人按要求提交全部补正材料的，发给申办人《申办药品经营许可证受理决定书》（式样见附件四），该受理决定书中注明的日期为受理日期。 
    第七条 省药品监督管理部门自受理申请之日起10个工作日内，依据药品批发企业设置标准对申报材料进行审查，作出是否同意筹建的决定，分别制作《山东省药品监督管理局同意开办药品经营企业批件》（式样见附件五）或《山东省药品监督管理局不同意开办药品经营企业批件》（式样见附件六），5个工作日内书面通知申办人，并在省药品监督管理部门政府网站公告。 
    第八条 申办人取得同意筹建的批准文件并完成筹建后，通过拟办企业所在地市级药品监督管理部门向省药品监督管理部门提出验收申请，并提交以下材料： 
    （一）药品经营许可证申请表（式样见附件七）； 
    （二）企业组织机构职能框图； 
    （三）依法经过资格认定的药学及相关专业技术人员资格证书及聘书复印件； 
    （四）企业质量管理文件目录； 
    （五）决定企业法定代表人或负责人的董事会决议或企业主管部门任命文件或企业任命文件； 
    （六）企业负责人员和质量管理人员情况表（式样见附件八，包括企业法定代表人、企业负责人、分管质量负责人、质量管理部门负责人、质量管理人员。以上人员自其他单位调入的，须出具由原单位或上级主管部门辞职或不在该单位工作的证明文件）； 
    （七）企业验收养护人员情况表（式样见附件九）； 
    （八）企业经营设施、设备情况表（式样见附件十）； 
    （九）经营场所功能布局平面图（标明详细地址、部门名称、面积）； 
    （十）仓库平面布局图（标明详细地址、仓库名称、总建筑面积、待验品库区、合格品库区、不合格品库区、退货库区、配送区、经营中药饮片的零货称取专库（区）及其面积，验收养护室及其面积、设施设备名称、位置）； 
    （十一）营业场所、仓库房屋产权或使用权证明。 
    第九条 市级药品监督管理部门收到企业验收申请后，应当在5个工作日内按《开办药品批发企业验收实施标准（试行）》进行初验，并填写《开办药品批发企业验收实施标准评定表》（式样见附件十一）报省药品监督管理部门。 
    第十条 省药品监督管理部门在收到市级药品监督管理部门初验材料及申办人填报的完整验收申请材料之日起20个工作日内，依据国家食品药品监督管理局《开办药品批发企业验收实施标准（试行）》组织验收，填写《开办药品批发企业验收实施标准评定表》（式样见附件十二），作出符合或不符合《开办药品批发企业验收实施标准》的结论。经验收不符合《开办药品批发企业验收实施标准（试行）》的，下达《药品批发企业验收整改通知书》（式样见附件十三），企业应当在30日内完成整改，提出复查申请，由省药品监督管理部门对整改情况组织验收。 
    第十一条 现场检查验收人员应当符合以下条件： 
    （一）药品监督管理部门的人员； 
    （二）GSP认证检查员。 
    第十二条 经现场验收符合标准的，省药品监督管理部门通过山东省药品监督管理部门政府网站向社会公示，公示期为10天。公示期满后，未提出异议的，省药品监督管理部门在5个工作日内发给《药品经营许可证》，并在省药品监督管理部门政府网站公告；提出异议的，待调查核实后再行处理。不符合条件的，省药品监督管理部门制作《开办药品批发企业不予发证通知书》（式样见附件十四），并在5个工作日内通知申办人。 
    第十三条 申办人认为申报材料完整或者筹建完成后达到验收标准要求，所在地市级药品监督管理部门无正当理由不予转呈申报材料或者不予现场初验的，申报人可将申报材料或者申请验收资料直接报省药品监督管理部门。 
    第十四条 申办人享有依法申请行政复议或者提起行政诉讼的权利。 
    第十五条  
    第十六条  
    第十七条 本程序自2004年4月1日起施行。 
      
      
      
      
              
      
      
      
      
      
    附件一： 
    药品经营许可证（批发）申请书 
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  申请人 
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 地址 
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 地址一 
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 地址二 
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 地址三 
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 （对拟经营范围在□内打√） 
  </td>
 <td width="518" colspan="17" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 388.7pt; padding-right: 5.4pt; height: 76.85pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">麻醉药品□、精神药品□、医疗用毒性药品□；生物制品□；中药材□、中药饮片□、中成药□、化学原料药□、化学药制剂□、抗生素原料药□、抗生素制剂□、生化药品□、诊断药品□。 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 27.95pt; mso-yfti-irow: 7">
 <td width="139" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 104pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">拟办企业法定 
 代表人 
  </td>
 <td width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="96" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">职务 
  </td>
 <td width="120" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 90pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="97" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72.5pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">技术职称、 
 学历 
  </td>
 <td width="98" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 73.3pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 27.95pt; mso-yfti-irow: 8">
 <td width="139" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 104pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">拟办企业 
 负责人 
  </td>
 <td width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="96" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">职务 
  </td>
 <td width="120" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 90pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="97" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72.5pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">技术职称、学历 
  </td>
 <td width="98" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 73.3pt; padding-right: 5.4pt; height: 27.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 35.95pt; mso-yfti-irow: 9">
 <td width="139" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 104pt; padding-right: 5.4pt; height: 35.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">拟办企业质量 
 负责人 
  </td>
 <td width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 35.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="96" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72pt; padding-right: 5.4pt; height: 35.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">职务 
  </td>
 <td width="120" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 90pt; padding-right: 5.4pt; height: 35.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="97" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72.5pt; padding-right: 5.4pt; height: 35.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">技术职称、 
 学历 
  </td>
 <td width="98" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 73.3pt; padding-right: 5.4pt; height: 35.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 46.3pt; mso-yfti-irow: 10">
 <td width="139" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 104pt; padding-right: 5.4pt; height: 46.3pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">拟办企业质量 
 管理部门负责人 
  </td>
 <td width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 46.3pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="96" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72pt; padding-right: 5.4pt; height: 46.3pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">从事药品经营管理工作年限 
  </td>
 <td width="120" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 90pt; padding-right: 5.4pt; height: 46.3pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="97" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72.5pt; padding-right: 5.4pt; height: 46.3pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">执业药师／ 
 技术职称 
  </td>
 <td width="98" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 73.3pt; padding-right: 5.4pt; height: 46.3pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 25.45pt; mso-yfti-irow: 11">
 <td width="139" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 104pt; padding-right: 5.4pt; height: 25.45pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">联 系 人 
  </td>
 <td width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 25.45pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="96" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72pt; padding-right: 5.4pt; height: 25.45pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">电话 
  </td>
 <td width="120" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 90pt; padding-right: 5.4pt; height: 25.45pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="97" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 72.5pt; padding-right: 5.4pt; height: 25.45pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">传真 
  </td>
 <td width="98" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 73.3pt; padding-right: 5.4pt; height: 25.45pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 21pt; mso-yfti-irow: 12">
 <td rowspan="3" width="43" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 32.25pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">人 
 员 
 情 
 况 
  </td>
 <td rowspan="2" width="96" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 71.75pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">职工总数 
  </td>
 <td rowspan="2" width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">从事质量管 
 理、验收、养 
 护人员总数 
  </td>
 <td width="410" colspan="16" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 307.8pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">药学技术人员数 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 21pt; mso-yfti-irow: 13">
 <td width="69" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 51.6pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">执业 
 药师 
  </td>
 <td width="57" colspan="4" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 42.6pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">主任药师 
  </td>
 <td width="67" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 50.3pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">副主任药师 
  </td>
 <td width="47" colspan="4" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 34.95pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">主管药师 
  </td>
 <td width="57" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 42.6pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">药师 
  </td>
 <td width="57" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 42.6pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">药士 
  </td>
 <td width="58" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 43.15pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">从业药师 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 19.25pt; mso-yfti-irow: 14">
 <td width="96" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 71.75pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="69" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 51.6pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: medium none; padding-top: 0cm; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="57" colspan="4" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 42.6pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: medium none; padding-top: 0cm; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="67" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 50.3pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: medium none; padding-top: 0cm; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="47" colspan="4" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 34.95pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: medium none; padding-top: 0cm; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="57" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 42.6pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: medium none; padding-top: 0cm; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="57" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 42.6pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: medium none; padding-top: 0cm; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="58" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 43.15pt; padding-right: 5.4pt; height: 19.25pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 21pt; mso-yfti-irow: 15">
 <td rowspan="2" width="139" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 104pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">仓库面积 
 （平方米） 
  </td>
 <td width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">总建筑面积 
  </td>
 <td width="111" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 83.55pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">常温库面积 
  </td>
 <td width="105" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 78.85pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">阴凉库面积 
  </td>
 <td width="94" colspan="4" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 70.5pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">冷库面积 
  </td>
 <td width="100" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 74.9pt; padding-right: 5.4pt; height: 21pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">验收养护室面积 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 50.7pt; mso-yfti-irow: 16; mso-yfti-lastrow: yes">
 <td width="108" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.9pt; padding-right: 5.4pt; height: 50.7pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="111" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 83.55pt; padding-right: 5.4pt; height: 50.7pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="105" colspan="6" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 78.85pt; padding-right: 5.4pt; height: 50.7pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="94" colspan="4" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 70.5pt; padding-right: 5.4pt; height: 50.7pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 <td width="100" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 74.9pt; padding-right: 5.4pt; height: 50.7pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr>
 <td width="43" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="96" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="108" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="69" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="27" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="15" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="9" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="5" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="67" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="12" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="12" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="1" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="23" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="49" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="7" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="14" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="2" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="40" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 <td width="58" style="border-bottom: medium none; border-left: medium none; border-top: medium none; border-right: medium none"> </td>
 </tr>
 </tbody>
</table>
                          年    月    日 
    附件二： 
    申办药品经营许可证材料初审转呈单 
<table class="MsoNormalTable" border="1" cellspacing="0" cellpadding="0" style="border-bottom: medium none; border-left: medium none; border-collapse: collapse; border-top: medium none; border-right: medium none; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-border-alt: solid black .75pt; mso-border-insideh: .75pt solid black; mso-border-insidev: .75pt solid black; mso-yfti-tbllook: 160">
 <tbody>
 <tr style="height: 39.7pt; mso-yfti-irow: 0">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 39.7pt; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt">申请人名称 
  </td>
 <td valign="top" width="379" colspan="2" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 284.1pt; padding-right: 5.4pt; height: 39.7pt; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="height: 39.7pt; mso-yfti-irow: 1">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">审查内容 
  </td>
 <td width="379" colspan="2" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 284.1pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">审查结果 
  </td>
 </tr>
 <tr style="height: 39.7pt; mso-yfti-irow: 2">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">企业法定代表人学历证明 
 原件、复印件及个人简历 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">原件与复印件一致，   □ 
 简历真实       □ 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">原件与复印件不一致， □ 
 简历不真实      □ 
  </td>
 </tr>
 <tr style="height: 39.7pt; mso-yfti-irow: 3">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">企业负责人学历证明原件、复印件及个人简历 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">原件与复印件一致，   □ 
 简历真实       □ 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">原件与复印件不一致， □ 
 简历不真实      □ 
  </td>
 </tr>
 <tr style="height: 57.35pt; mso-yfti-irow: 4">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 57.35pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">企业质量管理负责人学历、职称证明原件、复印件及个人简历 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 57.35pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">原件与复印件一致，   □ 
 简历真实       □ 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 57.35pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">原件与复印件不一致， □ 
 简历不真实      □ 
  </td>
 </tr>
 <tr style="height: 77.2pt; mso-yfti-irow: 5">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 77.2pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">企业法定代表人、企业负责人、质量管理负责人有无《药品管理法》第76条、第83条规定情形 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 77.2pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">无          □ 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 77.2pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">有          □ 
  </td>
 </tr>
 <tr style="height: 39.7pt; mso-yfti-irow: 6">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">执业药师（含执业中药师）执业证书原件、复印件 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">原件与复印件一致    □， 
 真实有效       □ 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">原件与复印件不一致， □ 
 不真实，无效     □ 
  </td>
 </tr>
 <tr style="height: 39.7pt; mso-yfti-irow: 7">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">工商行政管理局出具的拟办企业名称预先核准通知书 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">有          □ 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">无          □ 
  </td>
 </tr>
 <tr style="height: 39.7pt; mso-yfti-irow: 8">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">拟经营药品的范围 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">符合设置标准（或规定）    □ 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">不符合设置标准（或规定）     □ 
  </td>
 </tr>
 <tr style="height: 39.7pt; mso-yfti-irow: 9">
 <td width="189" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 142pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">拟设营业场所、仓库平面布局图及周边卫生环境情况 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">符合GSP规定     □ 
  </td>
 <td width="189" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 142.05pt; padding-right: 5.4pt; height: 39.7pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-left-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">不符合GSP规定    □ 
  </td>
 </tr>
 <tr style="height: 74.95pt; mso-yfti-irow: 10; mso-yfti-lastrow: yes">
 <td valign="top" width="568" colspan="3" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 426.1pt; padding-right: 5.4pt; height: 74.95pt; border-top: medium none; border-right: black 1pt solid; padding-top: 0cm; mso-border-alt: solid black .75pt; mso-border-top-alt: solid black .75pt">初审人签名：       
 <o:p> </o:p> 
     年   月   日 
  </td>
 </tr>
 </tbody>
</table>
      
    ××市药品监督管理局（盖章） 
      
       年   月   日 
    附件三： 
    山东省药品监督管理局 
    申办药品经营许可证补正材料通知书 
      
    编号：鲁200X000号 
      
           ： 
    根据国家食品药品监督管理局《药品经营许可证管理办法》及《山东省药品经营许可证（批发）企业申办程序》规定，你（单位）提交的开办药品批发企业申报材料不齐全或不符合法定形式，须在    
    1、 
    2、 
    3、 
    ┉┉┉ 
      
                 山东省药品监督管理局 
    年 月 日 
      
      
      
    附件四： 
    山东省药品监督管理局 
    申办药品经营许可证受理决定书 
                   
     编号：鲁200X000号 
      
           ： 
        根据国家食品药品监督管理局《药品经营许可证管理办法》及《山东省药品经营许可证（批发）申办程序》规定，你（单位）提交的开办药品批发企业申报材料齐全、符合法定形式，同意受理。 
      
      
      
                 山东省药品监督管理局 
    年 月 日 
      
      
      
      
      
      
    附件五： 
    山东省药品监督管理局 
    同意开办药品经营企业批件 
                  
                     编号：JYLX200XXXX 号 
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 <tbody>
 <tr style="page-break-inside: avoid; height: 30pt; mso-yfti-irow: 0">
 <td width="107" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.1pt; padding-right: 5.4pt; height: 30pt; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt">申请人 
 （单位） 
  </td>
 <td width="500" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 375.3pt; padding-right: 5.4pt; height: 30pt; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 29.55pt; mso-yfti-irow: 1">
 <td rowspan="8" width="107" style="border-bottom: black 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.1pt; padding-right: 5.4pt; height: 29.55pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid black .75pt">核准项目 
  </td>
 <td width="92" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 69.3pt; padding-right: 5.4pt; height: 29.55pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">企业名称 
  </td>
 <td width="408" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 306pt; padding-right: 5.4pt; height: 29.55pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 29.85pt; mso-yfti-irow: 2">
 <td width="92" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 69.3pt; padding-right: 5.4pt; height: 29.85pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">经营方式 
  </td>
 <td width="408" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 306pt; padding-right: 5.4pt; height: 29.85pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 45.75pt; mso-yfti-irow: 3">
 <td width="92" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 69.3pt; padding-right: 5.4pt; height: 45.75pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">经营范围 
  </td>
 <td width="408" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 306pt; padding-right: 5.4pt; height: 45.75pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">麻醉药品□、精神药品□、医疗用毒性药品□；生物制品□；中药材□、中药饮片□、中成药□、化学原料药□、化学药制剂□、抗生素原料药□、抗生素制剂□、生化药品□、诊断药品□。 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 27.3pt; mso-yfti-irow: 4">
 <td width="92" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 69.3pt; padding-right: 5.4pt; height: 27.3pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">注册地址 
  </td>
 <td width="408" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 306pt; padding-right: 5.4pt; height: 27.3pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 21.6pt; mso-yfti-irow: 5">
 <td rowspan="3" width="92" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 69.3pt; padding-right: 5.4pt; height: 21.6pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">仓库地址 
  </td>
 <td width="35" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 26.15pt; padding-right: 5.4pt; height: 21.6pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">一 
  </td>
 <td width="373" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 279.85pt; padding-right: 5.4pt; height: 21.6pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 27.45pt; mso-yfti-irow: 6">
 <td width="35" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 26.15pt; padding-right: 5.4pt; height: 27.45pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">二 
  </td>
 <td width="373" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 279.85pt; padding-right: 5.4pt; height: 27.45pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 25.05pt; mso-yfti-irow: 7">
 <td width="35" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 26.15pt; padding-right: 5.4pt; height: 25.05pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">三 
  </td>
 <td width="373" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 279.85pt; padding-right: 5.4pt; height: 25.05pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 48.95pt; mso-yfti-irow: 8">
 <td width="92" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 69.3pt; padding-right: 5.4pt; height: 48.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid black .75pt">法定代表人 
 （或负责人） 
  </td>
 <td width="408" colspan="2" style="border-bottom: black 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 306pt; padding-right: 5.4pt; height: 48.95pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid black .75pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 27pt; mso-yfti-irow: 9">
 <td width="107" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.1pt; padding-right: 5.4pt; height: 27pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">主送 
  </td>
 <td width="500" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 375.3pt; padding-right: 5.4pt; height: 27pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 27pt; mso-yfti-irow: 10">
 <td width="107" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.1pt; padding-right: 5.4pt; height: 27pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">抄送 
  </td>
 <td width="500" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 375.3pt; padding-right: 5.4pt; height: 27pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 75.9pt; mso-yfti-irow: 11; mso-yfti-lastrow: yes">
 <td width="107" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.1pt; padding-right: 5.4pt; height: 75.9pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid black .75pt">备注 
  </td>
 <td width="500" colspan="3" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 375.3pt; padding-right: 5.4pt; height: 75.9pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid black .75pt">该企业应严格按照《药品管理法》、《药品管理法实施条例》及《药品经营质量管理规范认证管理办法》的规定，在企业取得《药品经营许可证》后，1个月内，申请GSP认证。逾期未按规定申请GSP认证的，将依照《药品管理法》有关规定处理。 
  </td>
 </tr>
 </tbody>
</table>
      
    山东省药品监督管理局 
      
    年   月   日 
    附件六： 
    山东省药品监督管理局 
    不同意开办药品经营企业批件 
                  
                      编号：JYBLX200XXXX 号 
<table class="MsoNormalTable" border="1" cellspacing="0" cellpadding="0" width="607" style="border-bottom: medium none; border-left: medium none; width: 455.4pt; border-collapse: collapse; border-top: medium none; border-right: medium none; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-border-alt: solid black .75pt; mso-border-insideh: .75pt solid black; mso-border-insidev: .75pt solid black; mso-yfti-tbllook: 191">
 <tbody>
 <tr style="page-break-inside: avoid; height: 38.3pt; mso-yfti-irow: 0">
 <td width="107" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.1pt; padding-right: 5.4pt; height: 38.3pt; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt">申请人（单位） 
  </td>
 <td width="500" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 375.3pt; padding-right: 5.4pt; height: 38.3pt; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 295.05pt; mso-yfti-irow: 1">
 <td width="607" colspan="2" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 455.4pt; padding-right: 5.4pt; height: 295.05pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">你（单位）向我局提出的开办批发企业申请，经审查（申报材料与实际不符；申请单位中的人员不符合药品管理法第76条或第83条规定；人员配备不符合要求；经营场所不符合要求；仓储条件不符合要求等），依据（《药品管理法》、《药品管理法实施条例》、《药品经营质量管理规范》中第   条第   款），决定不同意你单位的申请。 
 你（单位）如不服本决定，可以在本决定书送达之日起60 
 日内向山东省人民政府或国家食品药品监督管理局申请行政复议或在三个月内向济南市中级人民法院提起行政诉讼。 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 46.9pt; mso-yfti-irow: 2">
 <td width="107" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.1pt; padding-right: 5.4pt; height: 46.9pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">主送 
  </td>
 <td width="500" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 375.3pt; padding-right: 5.4pt; height: 46.9pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><o:p> </o:p> 
  </td>
 </tr>
 <tr style="page-break-inside: avoid; height: 50.7pt; mso-yfti-irow: 3; mso-yfti-lastrow: yes">
 <td width="107" style="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-bottom: 0cm; padding-left: 5.4pt; width: 80.1pt; padding-right: 5.4pt; height: 50.7pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt">抄送 
  </td>
 <td width="500" style="border-bottom: windowtext 1pt solid; border-left: medium none; padding-bottom: 0cm; padding-left: 5.4pt; width: 375.3pt; padding-right: 5.4pt; height: 50.7pt; border-top: medium none; border-right: windowtext 1pt solid; padding-top: 0cm; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt"><span s