XLS《1》

"省本级职工工伤事故情况快报表" "单位代码: "单位名称:(章)填表日期:年月日",,

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"事故发生时间",,

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"事故发生地点"死亡人数",,

, "受伤人数",,

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"急救医院"急救科室",,

, "转诊医院"治疗科室",,

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,"一式两联" "事故经过: 经办机构留存②单位留存" "伤亡职工基本情况" "居民身份证号码",,

"姓名",,

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"性别",,

"年龄",,

"工种",,

"伤亡情况",,

"受伤部位",,

, "单位制表人(章)省社保中心(章)审核人(章)",,

, "单位法定代表人(章)负责人(章)",,

, "省本级工伤(亡)职工登记表" "单位代码: "单位名称:(章)填表日期:年月日",,

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"工伤职工基本情况","居民身份证号码"姓名",,

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"性别",,

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"年龄",,

"一式两联①经办机构留存②单位留存" ,"户籍类型"工种",,

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"劳动关系类型",,

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,"联系电话"联系地址" ,"开户银行名称"银行帐户" "工伤认定情况","工伤时间"工亡时间",,

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"申请工伤认定时间",,

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,"伤害部位" ,"职业病分类"职业病病种" ,"工伤认定依据"工伤类别",,

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, ,"工伤认定机构"工伤认定时间",,

,"年月日",,

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"工伤认定书编号",,

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, ,"停工留薪期限"起始时间",,

,"年月日",,

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"终止时间",,

"年月日",,

, "就医情况","就医类别"急救医院" ,"门诊医院"住院医院" ,"科别"床位号" "单位制表人(章)省社保中心(章)审核人(章)",,

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, "单位负责人(章)负责人(章)",,

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, "省本级工伤职工转诊转院申请表" "单位名称: "姓名",,

,"居民身份证号码",,

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"性别",,

"年龄",,

"工伤时间",,

,"伤残部位",,

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"工伤类别",,

"联系电话",,

,"联系地址" "工伤职工本人申请" ,,

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"本人签字:年月日",,

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, "用人单位意见" ,"(盖章) ,"经办人签字:年月日" "定点医疗机构意见" ,"(盖章) ,"医师签字:年月日" "省社保中心意见" ,,

"(盖章)盖章)", ,"(盖章) ,"经办人签字:年月日" "备注" "省本级工伤医疗待遇情况表" "单位代码: "单位名称:单位:元" "居民身份证号码"姓名"性别"年龄"一式三联①经办机构留存②单位留存③工伤职工留存" "医疗机构名称"医院级别"住院号" "住院日期"出院日期"住院天数" "伤害部位" "门诊诊断" "入院诊断" "出院诊断" "项目"序号"申报金额"不支付金额"支付金额" "医疗费",,

,"药品费"01" ,,

,"检查费"02" ,,

,"治疗费"03" ,,

,"手术费"04" ,,

,"医用材料费"05" ,,

,"全血及成分血费"06" ,,

,"康复费"07" ,,

,"其它"08" ,,

,"合计"09" "补助费",,

,"住院伙食补助"10" ,,

,"交通、食宿费"11" "支付金额合计(小写)12" "支付金额合计(大写)13" "开户银行名称"14"银行账户" "单位申报人(章)申报日期" "审核人(章)复核人(章)负责人(章)省社保中心(章) "(注:表中"不支付金额"、"支付金额"由经办机构审核后填写.

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"省本级工伤辅助器具配置(更换)费用表" "单位代码: "单位名称:填表日期:年月日" "居民身份证号码"姓名"性别",,

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"年龄",,

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,"一式三联①经办机构留存②单位留存③工伤职工留存" "伤残部位"配置辅助器具项目" "使用年限"配置时间" "更换时间"配置金额",,