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<body>
<div class="page">
<p style="font-size:22pt;text-align:center;">省级临床医学中心科研项目申请书</p>
<table class="head-tab-border">
<tr>
<td>项目名称：</td>
<td colspan="3" class="border_botttom"></td>
</tr>
<tr>
<td>申报单位：</td>
<td colspan="3" class="border_botttom"></td>
</tr>
<tr>
<td colspan="3">推荐部门（丙方）：</td>
<td class="border_botttom"></td>
</tr>
<tr>
<td colspan="2">项目负责人：</td>
<td colspan="2" class="border_botttom"></td>
</tr>
<tr>
<td>联系电话：</td>
<td colspan="3" class="border_botttom"></td>
</tr>
<tr>
<td>起止年限：</td>
<td colspan="3" class="border_botttom">年 月至 年 月</td>
</tr>
<tr>
<td>填报日期：</td>
<td colspan="3" class="border_botttom"></td>
</tr>
<tr>
<td style="width: 102px;"> </td>
<td style="width: 20px;"> </td>
<td style="width: 60px;"> </td>
<td> </td>
</tr>
</table>
</div>
<div class="page">
<table>
<tr>
<td rowspan="6">申请人信息</td>
<td>姓名</td>
<td colspan="2">name</td>
<td>性别</td>
<td colspan="2">sex</td>
<td>出生年月</td>
<td>2019-12</td>
<td>民族</td>
<td>汉族</td>
</tr>
<tr>
<td>学 位</td>
<td colspan="2"></td>
<td>职称</td>
<td colspan="3"></td>
<td colspan="2">每年工作时间（月）</td>
<td></td>
</tr>
<tr>
<td>电 话</td>
<td colspan="4"></td>
<td colspan="2">电子邮箱</td>
<td colspan="3"></td>
</tr>
<tr>
<td colspan="2">个人通讯地址</td>
<td colspan="8"></td>
</tr>
<tr>
<td colspan="2">工 作 单 位</td>
<td colspan="8"></td>
</tr>
<tr>
<td colspan="2">主要研究领域</td>
<td colspan="8"></td>
</tr>
<tr>
<td rowspan="3">申请单位信息</td>
<td>单位名称</td>
<td colspan="9"></td>
</tr>
<tr>
<td>联系人</td>
<td colspan="4"></td>
<td colspan="2">电话</td>
<td colspan="3"></td>
</tr>
<tr>
<td>电子信箱</td>
<td colspan="4"></td>
<td colspan="2">传真</td>
<td colspan="3"></td>
</tr>
<tr>
<td rowspan="2">合作单位</td>
<td colspan="10">1</td>
</tr>
<tr>
<td colspan="10">2</td>
</tr>
<tr>
<td rowspan="4">项目基本信息</td>
<td>项目名称</td>
<td colspan="9"></td>
</tr>
<tr>
<td>学科代码</td>
<td colspan="4"></td>
<td colspan="2">选题范围</td>
<td colspan="3"></td>
</tr>
<tr>
<td>项目类别</td>
<td colspan="4"></td>
<td colspan="2">附注说明</td>
<td colspan="3"></td>
</tr>
<tr>
<td>研究期限</td>
<td colspan="4"></td>
<td colspan="2">申请经费</td>
<td colspan="3"></td>
</tr>
<tr>
<td>项目摘要(400字)</td>
<td colspan="10"></td>
</tr>
<tr>
<td>关键词</td>
<td colspan="10"></td>
</tr>
</table>
</div>
<div class="page">
<p>项目组主要成员（注：不包括项目申请人）</p>
<table>
<tr>
<td>序号</td>
<td>姓名</td>
<td>出生年月</td>
<td>性别</td>
<td>职称</td>
<td>学位</td>
<td>工作单位</td>
<td>电话</td>
<td>电子邮箱</td>
<td>证件号码</td>
<td>项目分工</td>
<td>每年工作时间（月）</td>
</tr>
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</table>
<table>
<tr>
<td>总人数</td>
<td>高级</td>
<td>中级</td>
<td>初级</td>
<td>博士后</td>
<td>博士生</td>
<td>硕士生</td>
</tr>
<tr>
<td></td>
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</tr>
</table>
</div>
<div class="page">
<p>绩效目标表</p>
<table>
<tr>
<td colspan="20">年度</td>
</tr>
<tr>
<td>项目名称</td>
<td colspan="19"></td>
</tr>
<tr>
<td>主管处室</td>
<td colspan="10"></td>
<td colspan="2">实施单位</td>
<td colspan="7"></td>
</tr>
<tr>
<td>项目属性</td>
<td colspan="10">
</td>
<td colspan="2">项目期</td>
<td colspan="7"></td>
</tr>
<tr>
<td rowspan="3">项目资金(万元)</td>
<td colspan="2">总体资金总额：</td>
<td colspan="8"></td>
<td colspan="2">年度资金总额：</td>
<td colspan="7"></td>
</tr>
<tr>
<td colspan="2">其中：财政拨款</td>
<td colspan="8"></td>
<td colspan="2">其中：财政拨款</td>
<td colspan="7"></td>
</tr>
<tr>
<td colspan="2">其他资金</td>
<td colspan="8"></td>
<td colspan="2">其他资金</td>
<td colspan="7"></td>
</tr>
<tr>
<td rowspan="3">总体考核目标</td>
<td colspan="10">总体目标(年—年)</td>
<td colspan="9">分年度指标</td>
</tr>
<tr>
<td colspan="10" rowspan="2"></td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="3"></td>
</tr>
<tr>
<td colspan="3"></td>
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<td colspan="3"></td>
</tr>
<tr>
<td :rowspan="projectKPI.totalRowSpan"></td>
<td rowspan="2">一级指标</td>
<td rowspan="2">二级指标</td>
<td rowspan="2" colspan="6">三级指标</td>
<td rowspan="2">指标值</td>
<td rowspan="2">绩效标准</td>
<td rowspan="2">二级指标</td>
<td rowspan="2" colspan="5">三级指标</td>
<td colspan="3">指标值</td>
</tr>
</table>
</div>
<div class="page">
<p>项目经费预算表</p>
<p>金额单位：万元（保留两位小数）</p>
<table>
<tr>
<td>预算科目</td>
<td>总预算数</td>
<td>财政资金</td>
<td>自筹资金</td>
<td>备注</td>
</tr>
<tr>
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