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["上海健康医学院附属卫生学校"]
["解除学生违纪处分的申请表"]
["班级",null,null,"姓名"]
["学号",null,null,"性别"]
["所属系部",null,null,"受处分类别"]
["受处分日期",null,null,"受处分文号"]
["受处分原因"]
["本人申请","    "]
[null,"    申请人签名：                申请日期："]
["班主任意见","         同学在受处分期间认真检讨，深刻反省，积极改正错误，表现良好，经班级民主评议，同意解除该同学的           违纪处分。"]
[null,"    班主任签名：                  日期："]
["学生科意见","    为严肃校纪，教育本人，根据《上海市中等职业学校学生学籍管理实施办法》规定，经讨论决定，同意解除           同学的             违纪处分。      "]
[]
[]
[]
[null,"    签名（盖章）：                日期："]
["分管校领导意见","  分管校领导签名：                日期："]
["备注"]