扣分原因 | 扣分合计 | 备注 |
____________ | ____________ | ____________ |
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扣分原因 | 扣分合计 | 备注 |
____________ | ____________ | ____________ |
____________ | ____________ | ____________ |
扣分原因 | 扣分合计 | 备注 |
____________ | ____________ | ____________ |
____________ | ____________ | ____________ |
扣分原因 | 扣分合计 | 备注 |
____________ | ____________ | ____________ |
____________ | ____________ | ____________ |