询问笔录
时间_______年_______月_______日_______时_______分至_______年_______月_______日_______时_______分
地点________________________________________________________________
侦查员姓名、单位____________________________________________________
记录员______________________________________________________________
被询问人____________性别____________年龄____________单位____________
住址________________________________________________________________
问:______________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
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