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 苗圃名称___________________________                 抽样地点___________________________ 
树种_________________         苗木种类______________________         苗龄______________  
本批苗木数量___________________________株              抽样数量__________________________株 
质量等级________________________________              依据标准___________________________  
起苗日期________________________________             检验日期___________________________  
检验员____________________ 检验单位(盖章)____________________ 负责人____________________  |