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│ (此处印制公安机关名称) │
│ 出入境管理解除拘留审查决定书 │
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│ ×公( )行拘审解字[ ]第 号│
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│案 由_________________________________________________________________________│
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│违法嫌疑人____________________性别__________出生日期____________________________│
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│国籍/地区____________________证件名称及号码_____________________________________│
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│原拘留审查决定书文号____________________________________________________________│
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│解除拘留审查原因________________________________________________________________│
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│办案单位________________________________________________________________________│
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│承 办 人________________________________________________________________________│
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│批 准 人________________________________________________________________________│
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│执行单位________________________________________________________________________│
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│填 发 人________________________________________________________________________│
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│填发日期________________________________________________________________________│
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