医院复制病历资料申请书
第二篇：复制申请书
复 制 申 请 书
Reproduction Application
北京市新闻出版管理局：
Beijing Municipal Bureau of Press and Publication:
_____________委托北京海传光盘有限公司复制《__________》光盘____张，媒体形态为______，载体容量______，用于____________________________，为非卖品，版权归_______________所有，若因此出现的一切法律责任由我公司承担，光盘内容说明：______________________。
_____________ hereby entrusts Beijing Hitran Optical Disc Co., Ltd. to reproduce___ discs __________, of which the media type is______ and the capacity of the carrier is______. They are used for ____________________________ as products not for sales. The copyright belongs to _______________. Our company bears full legal responsibility raised therefore. The content of discs is ______________________.
《___________________》保证不含以下内容：
1、 反对宪法确定的基本原则的；
2、 危害国家的统一、主权和领土完整的；
3、 泄露国家机密、危害国家安全或者损害国家荣誉和利益的；
4、 煽动民族仇恨、民族歧视，破坏民族团结，或者侵害民主风俗、习惯的；
5、 宣扬邪教、迷信的；
6、 扰乱社会秩序，破坏社会稳定的；
7、 宣扬淫秽、赌博、暴力或者教唆犯罪的；
8、 侮辱或者诽谤他人，侵害他人合法权益的；
9、 危害社会公德或者民族优秀文化传统的；
10、有法律、行政法规和国家规定禁止的其他内容的。
The following contents are not being included in_______________:
(1) Those which object the basic principles determined in the Constitution;
(2) Those which endanger the unity of the nation, sovereignty or territorial integrity;
(3) Those which divulge secrets of the State, endanger national security or damage the honor or benefits of the State;
(4) Those which incite the national hatred or discrimination, undermine the solidarity of the nations, or infringe upon national customs and habits;
(5) Those which propagate evil cults or superstition;
(6) Those which disturb the public order or destroy the public stability;
(7) Those which propagate obscenity, gambling, violence or instigate crimes;
(8) Those which insult or slander others, or infringe upon the lawful rights and interests of others;
(9) Those which endanger public ethics or the fine folk cultural traditions;
(10) Other contents prohibited by laws, administrative regulations or provisions of the State.
特此申请，尽快批复为盼。
Looking forward to the early reply。
_______________________公司
_______________________
年 月 日 Date