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["    兰州市城关区职工工伤事故快报"]
["用人单位:(加盖印章)   填报时间:   年  月  日  时  分  "]
["序号","职工姓名","性别","年龄","受伤(死亡)时  间","受伤部位","受伤程度"]
[1]
["事故简况:"]
{"$rows_empty":24}
["  填报人:            职务:          电话:"]
[]
["收到报告时间:      年   月   日  时  分"]
[]
["说明:1、如一次事故有多人受伤,可在受伤职工基本情况栏扩展；"]
["     2、伤害事故发生24小时内通过电子邮箱或电话报社会保险行政部门；"]
["     3、电子邮箱：3431999494@qq.com，电话：8712006；"]
["     4、上报事故快报后，尽快按规定提交书面申报工亡材料，逾期社会保险部门不予受理其工伤认定申请。"]

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