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["全省残疾人基本服务状况和需求专项调查入户调查工作周报表"]
["       市（区）残疾人联合会（盖章）",{"$nulls":6},"            年   月   日"]
["项目        ","核查人数","底册导     出人数","已入     户人数","完成调    查人数","未完成      调查人数","入户调    查人数","电话调    查人数","备注：       1、已入户人数=完成调查人数+未完成调查人数；          2、完成调查人数=电话调查人数+入户调查人数；           3、入户调查率要大于95%。"]
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["理事长签字：",{"$nulls":6},"填报人："]

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