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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