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["清华大学实验用动物活动备案申请表"]
["填表日期：                                            填表人："]
["序号","学院/部门","实验室信息",null,null,"实验活动性质",null,null,"实验活动信息",null,"动物福利伦理审查信息",null,null,null,"实验用动物信息"]
[null,null,"实验室名称","实验室所在楼宇及房间号","项目负责人","实验活动类型","实验研究方向","生物安全等级","项目名称","实验活动起止日期","是否需要动物福利伦理审查","是否完成动物福利伦理审查","动物福利伦理审查单位","动物福利伦理审查编号","动物具体来源","动物名称","动物数量（以实际单位计量）"]
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["备注：本表适用于学校范围内在清华大学实验动物中心和非人灵长类研究平台许可外开展的实验用动物相关活动。"]

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