ࡱ> { gbjbjzz \]%( 000$TTTPtT;,,"NNN))):;;;;;;$k=@$;02&))2&2&$;00NN9;///2&V0N0N:/2&://V7@8N~ 9+d8 :O;0;8x@+@88@08P) 5!v/",#[)))$;$;/)));2&2&2&2&@))))))))) : Exeter Partnership NHS Trust Records Summary of major findings Dr Nicole Baur Introduction The Exeter Centre for Medical History (CMH) and the Devon Record Office (DRO) have collaborated in an interdisciplinary project on mental health treatment. The project was initially targeted for a period of three months (08 January to 07 April 2007), but owing to unexpected findings it was extended to the month of May 2007. The collaboration was initiated because the DRO had received a deposit of an estimated 30,000 Hospital Index Cards (HICs) and about 10,000 individual patient files from Digby, Exminster and Wonford House hospitals dating from 1870 to the early 1970s. Due to limitations in space the collection can only be temporarily housed at the DRO. The primary aim of the project therefore was the archival preservation of these data through cataloguing and digitalisation desirably with a wider (regional or even national) impact for the permanent retention of similar materials. In addition, the deposit was to be assessed for the quantity and quality of its contents, its historical importance and potential research value. Methodology The time allocated to this project did not allow for a thorough investigation of the entire deposit. We therefore decided to carry out a detailed investigation of a core sample of approximately ten to twenty percent. Negotiating a sample proved difficult, as we would end up almost certainly with a subpopulation instead of a representative sample, but eventually all team members agreed on concentrating on the earliest admissions (up to 1944 inclusive). Earlier files are commonly known to be the more florid files, but we hoped in particular that this selection would inform us about longstay patients as well as multiple readmissions. The time period would also include World Wars I and II as well as any potential impact of the revised 1930 Mental Health Act. Project activities were divided into several stages and guided by three principal questions and several related subquestions, which took into consideration the physical condition of the deposit, the quality of its information, and its potential for academic research. Progress was documented in monthly reports and discussed amongst all project members in several meetings. Our set of questions was: What is the role of the HICs within this deposit? What is the physical condition of the HICs (legibility, etc.)? What kind of information do HICs provide? How (if ever) do HICs relate to the files (filing / reference system)? What is the archival value of the files? What are the contents of the files like in terms of quantity and quality? Does the architecture / design of the files change over time? Do the files show value for permanent retention? If so, how can they be best preserved (database; photographic images, etc.)? Is there any indication for a proactive strategy for the retention of records? What is the value of the deposit in terms of future academic research? Is it possible to create a patient career by establishing links between patient care in the institution and the community? Once we had found that, although differing in number, the HICs and the files belonged to the same set and the Patients General Reference Numbers (PGRN) on the HICs were the key to the files, information provided on the HICs was used as the basis for building up a searchable MS ACCESS database. The individual patient files as well as additional documentary material available at the DRO completed this information and filled gaps in the database. Below is a brief outline of the major findings and methodological problems we encountered in trying to answer our guidance questions. Major findings and outputs a) Assessment of HICs Although the entire deposit was delivered from Wonford House Hospital, the HICs belonged to two different sets: patients treated at Exminster and Wonford House hospitals. They are cardboard cards in fairly good condition, as storage in metal boxes protected them from destructive influences. Legibility is good, as most sections show pre-printed options to ring (probably to make filling them in as little labour-intensive as possible). Information, however, is inconsistent, as eight different types of HICs were used, each of them relating to a particular time period. The HICs contain primarily socio-economic data (personal and contact details, occupation). Information on the patients medical history is limited to the diagnosis and dates of previous hospitalisation. The most important information is the PGRN, which proved to be the key to the individual patient files. Our detailed investigation and consultation of additional documentary evidence showed that the HICs have to be regarded as snapshots of a particular time, and that the information was not always reliable. They were filled in retrospectively (most likely in the 1960s), and therefore cover only the subpopulation of patients considered live in the system at that time. This turned out to be a major setback, as we had assumed they would cover all admissions, and based our database on them. Another difficulty we encountered was that patients were allocated a HIC on each admission, i.e. patients with multiple readmissions have several HICs (this explains the difference in number between HICs and patient files referred to above). Due to a change in the hospitals reference system in the early 1960s, some HICs were retrospectively renumbered, which makes it very difficult to locate all the corresponding files in the deposit, as not all of them underwent renumbering. The HICs might have been created as a quick reference to a patients details; we found them useful for research purposes only in connection with medical notes. Based on the HICs an initial database of 1,742 records was created containing admissions between 1870 and 1944. 1,095 of these referred to Exminster patients, 647 to patients treated in Wonford House Hospital. The database was later split into two tables: T1 (1870 to 1939) containing 1,274 records (464 W), and T2 (1940 to 1944) with 468 records (183 W). The assessment of the HICs and creation of the database took about a month, keeping us well within our set timeline. b) Assessment of files Assessing the patient files took up most of the project time. It meant to manually sort through the entire deposit, which had been put into storage in no particular order, in order to identify and retrieve the file related to the time period under consideration, whose condition and contents would then be analysed and interpreted. Trying to retrieve the files through the PGRN and / or admission date proved very difficult from the start. The files are stored in large envelops with the patients name, admission date and PGRN written on the front. In accordance with our selection criteria, I looked for all admissions up to 1944 inclusive and / or all PGRNs up to 23,000 for Exminster patients and 5,000 for Wonford House patients. It became soon evident that the deposit contains only fragmentary evidence of pre-1950s files and absolutely no files for patients treated in Wonford House, i.e. in a first step I retrieved only about 12% of the files I was hoping to find. New records were created for patients who were not yet in our database because no HIC existed probably because their cases were considered dormant at the time the HICs were filled in. Further investigation also revealed that a considerable number of files are labelled incorrectly, i.e. the dates and PGRN on the envelope of the file do not refer to the patients first admission, whereas the envelopes contain documentary evidence of previous admissions. Most of these accounted for new records in our database. In these cases a HIC might exist, but would have been left out when we created the database because the admission date and PGRN under which these patients are registered did not meet our principal search criteria. Eleven records referring to patients treated in Digby hospital were also added, as the deposit does not contain any Digby HICs. There are 27 more records, which mention previous admissions in most cases this information was provided by the patients relatives but as there is not sufficient evidence for the actual admission, these have been excluded from the database. The above mentioned changes increased the number of records to a total of 1,950 (677 W, 11 D). Of these 1,432 (493 W, 11 D) were admitted between 1870 and 1939, and 518 (184 W) between 1940 and 1944. I retrieved a total of 355 files referring to 342 patients (13 patients had two files), which is about 18% of files I was aiming to find. In addition, I discovered medical case notes, of which I am unsure whether they are originals or copies, in the stocks of the DRO for another 341 patients. In total, medical notes (files or case notes) exist for 35.6% of our records. The condition of the files varies very much, as does information in terms of quantity and quality. The earlier files are large sheets, often with pictures of the patient. Many are frayed or have parts missing. More recent files are little booklets, whose first page is a copy of the HIC. The presentation of information (keywords, sentences, or abbreviations / handwritten or typed) and the degree of legibility is largely dependent on the physician and / or nurses. Most files contain the case notes, the first sheet of which provides the patients personal and family details, medical history and contact details of relatives. The more modern files contain an increasing amount of information about the patients social and family backgrounds, including dates of birth and marriage, number and age of children, and housing conditions. Apart from these, the contents of the files are collections of loose sheets of papers, mostly correspondence with relatives, solicitors, and councils. An important document for research purposes is the slip of the Ministry of Health containing the National Insurance Number, as this might help establish linkages (see below). c) Evaluation of linkage information Examining these files revealed their potential for further academic research into the relation between institutional and community care. In this paragraph I am presenting facts that underpin this point. Many patients were frequently readmitted, and the table below shows the distribution of previous admissions and readmissions according to sex: AdmissiontotalmalefemalePrevious339143 (42.2%)196 (57.8%)RA1382139 (36.4%)243 (63.6%)RA216854 (32.1%)114 (67.9%)RA38828 (31.8%)60 (68.2%)RA44616 (34.8%)30 (65.2%)RA53012 (41.4%)18 (58.6%)RA6197 (38.9%)12 (61.1%)RA7134 (33.3%)9 (66.6%)RA8113 (30.0%)8 (70.0%RA981 (12.5%)7 (87.5%)RA1051 (20.0%)4 (80.0%)> 1052 (40.0%)3 (60.0%) The proportion of male to female patients in our database is 37.8% to 62.2%. As far as previous admissions are concerned, the ratio changes slightly to the disadvantage of male patients (maybe because some of them were treated in military hospitals before their admission to one of the three hospitals we investigated). Looking at readmissions, particularly multiple readmissions, however, demonstrates that more women than men are affected. Among the people with more than ten readmissions is one woman with 34 admissions between 1924 and 1969. I have tried to create a profile of patients with at least one readmission. The majority of them had been classified as voluntary or temporary patients at their first hospitalisation in one of the hospitals under consideration. Many returned as voluntary patients, and their frequent stays in the institution are usually limited to a few months. For 356 patients who were readmitted at least once the age on their first admission is available (see Appendix, Table 1). 19 were first admitted during adolescence. They are six boys and 15 girls. My assumption that they were suffering from congenital mental illness turned out to be wrong, as the majority was treated for conditions such as schizophrenia, mania and depression. Interestingly, however, only one of them was readmitted a second. The age groups most likely to be readmitted were people between 35 to 39 and 45 to 49 at their first admission, several of them returned more than once. A look at multiple readmissions (i.e. five and more) reveals that these patients do not fall into the above age group. The majority of them are in their twenties and early thirties at their first admission. Patients with multiple readmissions usually return to the hospital within regular intervals with weeks or months in between two admissions. Some other patients, however, return to the hospital ten, twenty or even fifty years after their first admission. 339 patients had been treated in a hospital at least once prior to their admission to one of the three hospitals we were investigating. 76 of these were transferred from those hospitals to Digby / Exminster / Wonford House, and ten were again transferred after having had treatment there. Given these findings, I think, it would be very interesting to explore these different patterns of returning and non-admissions in a longer research project to particularly explore the relationship between institutional and community treatment. Looking into the setting of the hospital could reveal insights on what special environment the hospital provided, how this changed over time, and how these changes affected (re-)admissions. The topic of linkages between treatment in the hospital and community has hardly been touched so far, probably because, as in our case, it proves to be very difficult. Satellite connections, i.e. units in the community offering treatment and therefore holding patient records, are not easy to discover. The files give very little evidence of links to community care (e.g. names of doctors), and the NI number, which might provide a link, is available for only 94 patients in our sample. A meeting with Nick Hopkinson and Emmy Lloyd, who are involved in the preservation of records at Wonford House Hospital, was arranged during the course of the project and shed light on modern proceedings. It was marginally helpful for our project, as it turned out that there are more patient files at Wonford House Hospital, which might relate to the deposit we have investigated. Nick and Emmy offered to look into this matter. Other than that we learned that files, as property of the institution / unit providing treatment, do never follow patients around, i.e. in order to trace a patients career well have to identify all the places they were treated and unearth the relevant records. John Draisey has been trying to make a start by contacting people dealing with community records, but was only marginally successful, as interest from social services seems to be low. Conclusion The project has achieved its primary archival aim in cataloguing a sample of the earliest patients through the assessment of HICs, patient files and other related documents. The major physical output is a searchable MS ACCESS database covering admissions to Digby, Exminster and Wonford House Hospitals between 1870 and 1944. Although a step into the right direction, the database in its current form cannot serve as a model for sampling and archiving this kind of data. It would need further improvements and linkages to visual materials. Although we originally aimed for the digital preservation of the files, we later discarded this idea as too labour intensive for the short time period available. Our findings show, however, that it is certainly desirable to complete the database by adding the remaining approximately 9,000 patient files, which would be possible with funding for an estimated 6 months. Assessing the patient files and HICs has highlighted a lot of methodological problems. It has demonstrated how difficult it can be to work with a historical artefact such as the HICs and try to relate them to a deposit of entirely unsorted patient files. It made us think about how to deal with fragmentary or missing files. But most of all it has taught us how difficult it is to get hold of records in order to establish links to community care. The project has revealed flaws in how institutions as well as social services deal with records and shows that immediate action is required. Thanks to Johns efforts, we got hold of the Social Services Retention Policy, which tells us what (should) happen(s) to modern mental health records. The fact that it does not allow for a permanent retention of records makes our project the more valuable. The project has shown that archival and research issues are tied closely together, and it shows considerable potential for further research into mental health treatment in the institution and community. Interesting research topics are readmissions, periods of non-admission, impact of war, possible therapeutic impacts [drugs]. An application to a major funding body in order to get the financial resources to investigate one or more of these issues is certainly worth submitting. Appendix Table 1: Readmissions according to age & age groups on their first admission Age GroupTotalAge at 1st admissionmalefemale< 201913101501161217101825191520 to 24302061210322232362241725 to 29322523261227662831293530 to 343530353121132313313345135 to 3958356436310374538410393940 to 44364025411542474324441545 to 49454527461547464825494950 to 543650310512252135324544555 to 59295523562557065813593460 to 64196022612062146313640465 to 699651066116732680170 to 74570107220730275 to 79376017802 Table 2: Structure of the MS ACCESS Database InformationACCESS ColumnDescription of columnPossible entriesTotal number* Administration & Linkage InformationGenRefGeneral Reference Numbernumber VB = voluntary boarder NK = unknownn = 1950NRefNew Reference Numbern = 747HospHospitalD = Digby E = Exminster W = Wonford House n = 1950NINational Insurance Numbern = 94FilePatient file availabley = file available y(2) = 2 files available (y) = fragmentary file n = 355APAdmission Papers available n = 101C/PatRegEntry in Patients or Civil Registern = 783LeavRegEntry in Leaving Registern = 589MedNotesMedical Notes availableCB = case book CN = case notes (doctor / nurse) MR = medical records n = 354 Contact DetailsLNamePatients last namen = 1950FNamePatients first namen = 1950MName1Patients middle namen = 1294MName2Patients middle namen = 156AdmC/OPatient in care of s.o. before admissionn = 19AdmHNoHouse numbern = 747AdmHNameName of Housen = 782AdmPhPhone numbern = 4AdmStStreetn = 923AdmAdAdditional element of addressn = 335AdmCityCity / Townn = 1562AdmCountyCountyn = 1561NoKTitleTitle of Next of kinn = 975NoKFNameFirst name of Next of kinn = 989NoKNameLast name of Next of kinn = 1113NoKRelRelation Next of kinn = 877NoKHNoHouse number of Next of kinn = 476NoKHNameHouse name of Next of Kinn = 417NoKStStreet of Next of Kinn = 719NokCityCity of Next of Kinn = 1012NoKCountyCounty of Next of Kinn = 1006 Personal DetailsSexPatients sexF = female M = malen = 1950MStatePatients marital stateDivorced Married Judicially separated Separated Single Widowed n = 1795 NePatients maiden namen = 20ReligionPatients religionAnglican Anglo-Catholic Baptist Bible Christian Brethren Church of England (C of E) Church of Scotland Catholic Apostolic Christian Christian Scientist Congregationalist Dissenter Episcopalian Jewish Methodist No religion Non-Conformist (Non-Con.) Plymouth Brethren Presbyterian Protestant Roman Catholic (RC) Salvation Army Society of Friends Unitarian Wesleyan Wesleyan Methodist unknownn = 1593DoBPatients Date of Birthn = 726DoBYPatients Year of Birthn = 553Professional InformationOccupationPatients occupationExcluding not stated (29 patients)n = 1485IndustryIndustryn = 579 Admission InformationAdmDateDate of admissionn = 1949AdmAgeAge on admissionn = 1929AdmTypeType of admission Direct Indirectn = 1761AdmIndIndirect AdmissionReadmission due to elapsed order Statutory readmission Statutory transfer Transfern = 232TransferHTransferred from what hospitaln = 169CriminalConvicted patientCriminal None n = 1596ChargeChargeabilityHealth System (HS) Pauper Private Rate-aided (RA) Servicen = 1769 Removal InformationLeavDatDate of discharge, transfer or deathn = 1773LeavAgeAge on discharge transfer or deathn = 441OutcomeOutcomen = 1280DisposalDisposaltransferred discharged died departedn = 1691LeavC/OPatient in care of s.o. on leavingn = 75LeavHNoHouse number on leavingn = 160LeavHNameName of Housen = 419LeavPhPhone numbern = 1LeavStStreetn = 235LeavAdAdditional element of addressn = 74LeavCityCity / Townn = 586LeavCountyCountyn = 583 Death InformationCoD (Ia)Principal cause of death**n = 804CoD (Ib)Principal cause of deathn = 288CoD (Ic)Principal cause of deathn = 48CoD (II)Secondary cause of deathn = 128LeavAgeAge on Deathn = 808 Legal InformationAdmStatStatus on admissionCertified Temporary Voluntary Voluntary Boardern = 1935RegrStat1Status to which regradedCertified Informal Sec. 5 Temporary Voluntaryn = 677RegrDat1Date on which regradedn = 669RegrStat2Status to which regarded, if second regradingCertified Informal Sec. 5 Temporary Voluntaryn = 223RegrDat2Date on which regradedn = 222LeavStatStatus on dischargen = 1611 Medical ConditionPDiaPrincipal Diagnosisn = 1754SecConSecondary Conditionn = 56NoteDiaAny notes concerning the diagnosisn = 387Medical HistoryPADateDate of previous admissionn = 139PLDateDate of previous discharge or transfern = 95PHospName of hospital of previous treatmentn = 339MorePAMore than one previous admissionn = 78RA1Date of readmissionn = 382Leav1Date of leaving after readmissionn = 353RARef1Reference number of readmissionn = 356RA2Date of readmissionn = 168Leav2Date of leaving after readmissionn = 162RARef2Reference number of readmissionn = 162RA3Date of readmissionn = 88Leav3Date of leaving after readmissionn = 86RARef3Reference number of readmissionn = 85RA4Date of readmissionn = 46Leav4Date of leaving after readmissionn = 46RARef4Reference number of readmissionn = 45RA5Date of readmissionn = 30Leav5Date of leaving after readmissionn = 29RARef5Reference number of readmissionn = 30RA6Date of readmissionn = 19Leav6Date of leaving after readmissionn = 18RARef6Reference number of readmissionn = 19RA7Date of readmissionn = 13Leav7Date of leaving after readmissionn = 12RARef7Reference number of readmissionn = 13RA8Date of readmissionn = 11Leav8Date of leaving after readmissionn = 11RARef8Reference number of readmissionn = 12RA9Date of readmissionn = 9Leav9Date of leaving after readmissionn = 9RARef9Reference number of readmissionn = 7RA10Date of readmissionn = 6Leav10Date of leaving after readmissionn = 6RARef1Reference number of readmissionn = 6MRAMore readmissionsn = 5Hereditary InformationHereditaryInsanity of family membersn = 268General remarksNotesn = 154  W = Wonford House Hospital  D = Digby Hospital  An outline of the (merged) database with all 104 fields and possible entries can be found in the appendix of this report  A questionmark in a cell means that I was unable to retrieve this information because it was either ambiguous (most likely placenames) or illegible  Empty cells in the General Reference column are coded NK, as this field may later function as a primary key, which does not allow empty cells  Only applicable if DoB is not available     PAGE  PAGE 1 M  P Z [ p | DagmntwBKv(H mt<g123Hy^ hKjh70JU hRh7 hRhRhR h76] h61h61 h61h7 h76h61h7 h75H%?NO\o p | yz  =|`k-.$ & Fa$$ & Fa$$ & Fa$$a$$a$.uv_ ` w !(*`/a//000000 $$Ifa$gdn$a$ I!M!~!!!"="C"##T###$ $$$0$<$%%%%%&& &<&o'(((((^)_)a)b)x){)))))))))))))"*&*[*a*y*|********++........./ hx@h7hXh-lhQjh70JUhx@h[%h\(h$-h :hl~h7hKM/d//070<0J0P0Q0R0y0z0{00000001 1 11111111111 111111111111111 2 2J2O2P2Q2Z2ôôôôôôôååååååååÖhnhPCJOJQJaJhnhf-^CJOJQJaJhnhfMCJOJQJaJhnh^CJOJQJaJhnhZCJOJQJaJh^hh4jh/h( hfMh( hfMhfMhfMhLj h75001-! $$Ifa$gdnkd$$Ifl\ 6E8  t(0644 lap(ytn1 11#1$1(1<0 $$Ifa$gdnkd!$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdn(1,181D1E1I1<0 $$Ifa$gdnkd$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdnI1M1X1d1e1i1<0 $$Ifa$gdnkd$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdni1l1w1111<0 $$Ifa$gdnkd$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdn111111<0 $$Ifa$gdnkdu$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdn111111<0 $$Ifa$gdnkdJ$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdn111111<0 $$Ifa$gdnkd$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdn111111<0 $$Ifa$gdnkd$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdn11 2222<0 $$Ifa$gdnkd$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdn22#2-2.232<0 $$Ifa$gdnkd$$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdn3252?2I2J2O2<0 $$Ifa$gdnkds $$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdnO2Q2[2e2f2g24<77$a$kdH $$Ifl\ 6E8 t0644 lap(ytn $$Ifa$gdnZ2[2d2f2g2g3l3q3v3~3333333333!444444444l5m5n5o5555555576D6\6]666^778:89ʾ¾¾ʺ~h,ch**hhT#hN hXhX hXhrR hXhf hXhnhXhQh3Q9hf-^h4jhtahhfMhRhhnhPCJOJQJaJhnhf-^CJOJQJaJ1445:(;<>2B3B>BEIJJJKRKSK]KcKxK}KK $$Ifa$gdn $$Ifa$gdn$a$gdvI$a$9d9e9i9j9y99999:::: : :3:A::::::::::;&;(;;<<<<<!=+=1=8========3><>>>>>>>;?BCCCCDE:EBEEEEEF GGGGH8H@HHHHH`JJJJJJKSKkKmK\N^NdNeNgNNNɺɦՓhLQhCJOJQJaJh? h]thnh,cCJH*OJQJaJhnh,cCJOJQJaJh,ch,ch,c5hh:J hh7h h76] h75hyhayh72KKkd $$Iflr8p@ 8  t20644 lap2ytnKKKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdT $$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkd\ $$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdV$$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdP$$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdJ$$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdD$$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdL$$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdT$$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdN$$Ifl4r8p@ 8 t0644 lap2ytnKKKK $$Ifa$gdnKKKK/## $$Ifa$gdnkdH$$Ifl4r8p@ 8 t0644 lap2ytnKKLL $$Ifa$gdnLL LL/## $$Ifa$gdnkdB$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkdJ$$Ifl4r8p@ 8 t0644 lap2ytnLLL L $$Ifa$gdn L!L"L#L/## $$Ifa$gdnkdR$$Ifl4r8p@ 8 t0644 lap2ytn#L&L(L*L $$Ifa$gdn*L+L,L-L/## $$Ifa$gdnkdL$$Ifl4r8p@ 8 t0644 lap2ytn-L0L2L4L $$Ifa$gdn4L5L6L7L/## $$Ifa$gdnkdF$$Ifl4r8p@ 8 t0644 lap2ytn7L:LL $$Ifa$gdn>L?LHLKL/## $$Ifa$gdnkd@$$Ifl4r8p@ 8 t0644 lap2ytnKLNLPLRL $$Ifa$gdnRLSLTLUL/## $$Ifa$gdnkdH$$Ifl4r8p@ 8 t0644 lap2ytnULXLZL]L $$Ifa$gdn]L^L_L`L/## $$Ifa$gdnkdP$$Ifl4r8p@ 8 t0644 lap2ytn`LcLeLgL $$Ifa$gdngLhLiLjL/## $$Ifa$gdnkdJ$$Ifl4r8p@ 8 t0644 lap2ytnjLmLoLqL $$Ifa$gdnqLrLsLtL/## $$Ifa$gdnkdD$$Ifl4r8p@ 8 t0644 lap2ytntLwLyL{L $$Ifa$gdn{L|LLL/## $$Ifa$gdnkd> $$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkdF!$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkdN"$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkdH#$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkdB$$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkd<%$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkdD&$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkdL'$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkdF($$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLL/## $$Ifa$gdnkd@)$$Ifl4r8p@ 8 t0644 lap2ytnLLLL $$Ifa$gdnLLLM/## $$Ifa$gdnkd:*$$Ifl4r8p@ 8 t0644 lap2ytnMMM M $$Ifa$gdn M M M M/## $$Ifa$gdnkdB+$$Ifl4r8p@ 8 t0644 lap2ytn MMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkdJ,$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMM M/## $$Ifa$gdnkdD-$$Ifl4r8p@ 8 t0644 lap2ytn M#M%M'M $$Ifa$gdn'M(M)M*M/## $$Ifa$gdnkd>.$$Ifl4r8p@ 8 t0644 lap2ytn*M-M/M1M $$Ifa$gdn1M2M;M>M/## $$Ifa$gdnkd8/$$Ifl4r8p@ 8 t0644 lap2ytn>MAMCMFM $$Ifa$gdnFMGMHMIM/## $$Ifa$gdnkd@0$$Ifl4r8p@ 8 t0644 lap2ytnIMLMNMPM $$Ifa$gdnPMQMRMSM/## $$Ifa$gdnkdH1$$Ifl4r8p@ 8 t0644 lap2ytnSMVMXMZM $$Ifa$gdnZM[M\M]M/## $$Ifa$gdnkdB2$$Ifl4r8p@ 8 t0644 lap2ytn]M`MbMdM $$Ifa$gdndMeMfMgM/## $$Ifa$gdnkd<3$$Ifl4r8p@ 8 t0644 lap2ytngMjMlMnM $$Ifa$gdnnMoMxM{M/## $$Ifa$gdnkd64$$Ifl4r8p@ 8 t0644 lap2ytn{M~MMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd>5$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkdF6$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd@7$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd:8$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd49$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd<:$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkdD;$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd><$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd8=$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd2>$$Ifl4r8p@ 8 t0644 lap2ytnMMMM $$Ifa$gdnMMMM/## $$Ifa$gdnkd:?$$Ifl4r8p@ 8 t0644 lap2ytnMMNN $$Ifa$gdnNNNN/## $$Ifa$gdnkdB@$$Ifl4r8p@ 8 t0644 lap2ytnN N N N $$Ifa$gdn NNNN/## $$Ifa$gdnkdC$$Ifl4r8p@ 8 t0644 lap2ytn-N0N2N4N $$Ifa$gdn4N5N6N7N/## $$Ifa$gdnkdFD$$Ifl4r8p@ 8 t0644 lap2ytn7N:NN $$Ifa$gdn>N?NHNJN/## $$Ifa$gdnkd@E$$Ifl4r8p@ 8 t0644 lap2ytnJNMNONQN $$Ifa$gdnQNRNSNTN/## $$Ifa$gdnkd:F$$Ifl4r8p@ 8 t0644 lap2ytnTNWNYN[N $$Ifa$gdn[N\N]N^NN/***$a$kdBG$$Ifl4r8p@ 8 t0644 lap2ytnNNNNNNN $$Ifa$gd$a$NNNNNNDOEOQOROSO[O\OyOOOOOOOOOO P6P555 $IfgdkdK$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdOOOOOO P5kdK$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd PP6PMPNPVPWP5kdL$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $IfgdRPUPVPXPZP]PdPePjPwPxPPPPPPPPPPPPPPPPPPPPPPPMQVQQQQQQQQQQR R R>RDRER\RcRdR~RRRRRRRRRӸǸǸǸǸӛhd5CJOJQJaJhLQhNG_5CJOJQJaJhLQhNG_CJOJQJaJhNG_CJOJQJaJhLQhCJOJQJaJhLQh5CJOJQJaJhNG_5CJOJQJaJ=WPXP[PvPwPxPP $$Ifa$gd $IfgdPPPPPPPJAAAA5 $$Ifa$gd $IfgdkdiM$$Ifl4rd' 6$ j p t0%644 laPPPPPPPJAAAA5 $$Ifa$gd $Ifgdkd1N$$Ifl4rd' 6$ j p t0%644 laPPPPQQ8QMQJAAAAAA $IfgdkdN$$Ifl4rd' 6$ j p t0%644 laMQNQVQWQXQYQZQ>555 $IfgdkdO$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdZQ[Q\Q]Q^Q_QoQuQQQQ $$Ifa$gd $Ifgd QQQQQQQJAAAA5 $$Ifa$gd $IfgdkdP$$Ifl4rd' 6$ j p t0%644 laQQQQQQQJAAAA5 $$Ifa$gd $IfgdkdQQ$$Ifl4rd' 6$ j p t0%644 laQQQQRR RJAAAA5 $$Ifa$gd $IfgdkdR$$Ifl4rd' 6$ j p t0%644 la R R RR=R>RERJAAAA5 $$Ifa$gd $IfgdkdR$$Ifl4rd' 6$ j p t0%644 laERFRGRNR[R\RdRJAAAA5 $$Ifa$gd $IfgdkdS$$Ifl4rd' 6$ j p t0%644 ladReRfRoR}R~RRJAAAA5 $$Ifa$gd $IfgdkdqT$$Ifl4rd' 6$ j p t0%644 laRRRRRRRJAAAA5 $$Ifa$gd $Ifgdkd9U$$Ifl4rd' 6$ j p t0%644 laRRRRRRRJAAAA5 $$Ifa$gd $IfgdkdV$$Ifl4rd' 6$ j p t0%644 laRRRRRRRJAAAA5 $$Ifa$gd $IfgdkdV$$Ifl4rd' 6$ j p t0%644 laRRRSS SS%S&SGSNSOSuS|S}SSSSSSSSSSS%T,T-TLTSTTTsT{T|TTTTTTTKUMUUUWUtUzU{UkVVW'W(WGWNWOWUWVWpWwWӹӹӦӹӹӔӹ#jh_0JCJOJQJUaJ$hLQhCJOJQJaJmH sH h_5CJOJQJaJhD55CJOJQJaJhLQhCJOJQJaJhLQh5CJOJQJaJhd5CJOJQJaJ:RRRRRS SJAAAA5 $$Ifa$gd $IfgdkdW$$Ifl4rd' 6$ j p t0%644 la S S SSSS&SJAAAA5 $$Ifa$gd $IfgdkdYX$$Ifl4rd' 6$ j p t0%644 la&S'S(S1SFSGSOSJAAAA5 $$Ifa$gd $Ifgdkd!Y$$Ifl4rd' 6$ j p t0%644 laOSPSQSZStSuS}SJAAAA5 $$Ifa$gd $IfgdkdY$$Ifl4rd' 6$ j p t0%644 la}S~SSSSSSJAAAA5 $$Ifa$gd $IfgdkdZ$$Ifl4rd' 6$ j p t0%644 laSSSSSSSJAAAA5 $$Ifa$gd $Ifgdkdy[$$Ifl4rd' 6$ j p t0%644 laSSSSSSSJAAAA5 $$Ifa$gd $IfgdkdA\$$Ifl4rd' 6$ j p t0%644 laSTT T$T%T-TJAAAA5 $$Ifa$gd $Ifgdkd ]$$Ifl4rd' 6$ j p t0%644 la-T.T/T5TKTLTTTJAAAA5 $$Ifa$gd $Ifgdkd]$$Ifl4rd' 6$ j p t0%644 laTTUTVT^TrTsT|TJAAAA5 $$Ifa$gd $Ifgdkd^$$Ifl4rd' 6$ j p t0%644 la|T}T~TTTTTJAAAA5 $$Ifa$gd $Ifgdkda_$$Ifl4rd' 6$ j p t0%644 laTTTTTTTTJAAAAAA $Ifgdkd)`$$Ifl4rd' 6$ j p t0%644 laTTTTTT U5kd`$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd UUU2UY?YjYrYsYYYYZZZ4Z5ZIZMZPZ෫ӎ~qh 55CJOJQJaJhLQhCJH*OJQJaJhLQh 5CJOJQJaJhx^5CJOJQJaJh CJOJQJaJhLQh CJOJQJaJh5CJOJQJaJh_5CJOJQJaJhLQhCJOJQJaJhLQh5CJOJQJaJ,xWyWWWWWWJAAAAA $Ifgdkdd$$Ifl4rd' 6$ j p t0%644 laWWWWWWW>5555 $IfgdkdMe$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdWWWWXX/X>5555 $Ifgdkdf$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd/X0X9X:X;XBXSX5kdf$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $IfgdSXTX]X^X_XgXzX5kd{g$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $IfgdzXXXXXXX5kd5h$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $IfgdXXXXXY Y $$Ifa$gd $Ifgd Y Y YY5Y6Y>YJAAAA5 $$Ifa$gd $Ifgdkdh$$Ifl4rd' 6$ j p t0%644 la>Y?Y@YIY[YdYjYJAAAAA $Ifgdkdi$$Ifl4rd' 6$ j p t0%644 lajYsYtYuY|YYY>5555 $Ifgdkdcj$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdYYYYYYY5kdk$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $IfgdYYYYZZZ $$Ifa$gd $IfgdZZZ$ZHZIZQZJAAAA5 $$Ifa$gd $Ifgdkdk$$Ifl4rd' 6$ j p t0%644 laPZQZdZlZmZZZZZZZZ[[[*[1[2[I[O[`[g[h[[[[[[[[[[[ \\\:\A\B\g\m\n\\\\\\\\\]#]$]w]~]]]]]^^^=^D^E^e^m^n^^^^^^h/I5CJOJQJaJh 55CJOJQJaJh_5CJOJQJaJhLQhCJOJQJaJhLQh5CJOJQJaJHQZRZSZ[ZcZdZmZJAAAA5 $$Ifa$gd $Ifgdkdl$$Ifl4rd' 6$ j p t0%644 lamZnZoZxZZZZZJAAAAAA $IfgdkdKm$$Ifl4rd' 6$ j p t0%644 laZZZZZZZ5kdn$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $IfgdZZZZZZ[5kdn$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd[[[[[[)[5kdyo$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd)[*[2[3[4[;[H[5kd3p$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $IfgdH[I[O[P[Q[X[_[5kdp$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd_[`[h[i[j[q[[5kdq$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd[[[[[[[5kdar$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd[[[[[[[5kds$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd[[[[[[[5kds$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd[ \ \\\\ \5kdt$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd \9\:\B\C\D\M\5kdIu$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $IfgdM\f\g\n\o\p\y\5kdv$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgdy\\\\\\\5kdv$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd\\\\\\\5kdww$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd\\\\\ ]]$] $$Ifa$gd $Ifgd$]%]&]0]I]S]\]c]JAAAAAA $Ifgdkd1x$$Ifl4rd' 6$ j p t0%644 lac]m]w]]]]]5kdx$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd]]]]]]]5kdy$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd $Ifgd]]]]]^^^ $$Ifa$gd $Ifgd^^^%^<^=^E^JAAAA5 $$Ifa$gd $Ifgdkd_z$$Ifl4rd' 6$ j p t0%644 laE^F^G^P^d^e^n^JAAAA5 $$Ifa$gd $Ifgdkd{$$Ifl4rd' 6$ j p t0%644 lan^o^p^^^^^JAAAAA $Ifgdkd{$$Ifl4rd' 6$ j p t0%644 la^^^^^^^>5555 $Ifgdkd|$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd^^^^^^_4_;_<_m_s_t_____________``,`3`4`^`e`f`````````` aaa;aAaBalarasaaaaaaaaӹӹӹӪӹӹӹӹӹӹӹӹӹӹӹh=g5CJOJQJaJh=gCJOJQJaJhLQh=gCJOJQJaJhVDT5CJOJQJaJh/I5CJOJQJaJhLQhCJOJQJaJhLQh5CJOJQJaJhwwQ5CJOJQJaJ9^^^^^^^>5555 $IfgdkdG}$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd^____3_4_>5555 $Ifgdkd~$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd4_<_=_>_E_l_m_>5555 $Ifgdkd~$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdm_t_u_v_|___>5555 $Ifgdkdu$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd_______>5555 $Ifgdkd/$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd_______>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd_``` `+`,`>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd,`4`5`6`=`]`^`>5555 $Ifgdkd]$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd^`f`g`h`l```>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd```````>5555 $Ifgdkdу$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd```````>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd`````a a>5555 $IfgdkdE$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd aaaaa:a;a>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd;aBaCaDaKakala>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdlasatauayaaa>5555 $Ifgdkds$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdaaaaaaa>5555 $Ifgdkd-$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdaaaaaaa>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdaaabbbEbKbLbvb|b}bbbbbbbbccc#c$cOcUcVccccccccccd d d d'd)d,d-dXd]d^dddddddddd eee+e0e1epewexeeeeeeeeeeeeehjh0JUhhLQhCJOJQJaJhLQh5CJOJQJaJhVDT5CJOJQJaJLaaaaabb>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdbbbb"bDbEb>5555 $Ifgdkd[$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdEbLbMbNbUbubvb>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdvb}b~bbbbb>5555 $Ifgdkdϋ$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdbbbbbbb>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdbbbbbbb>5555 $IfgdkdC$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdbcccccc>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdc$c%c&c,cNcOc>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdOcVcWcXc_ccc>5555 $Ifgdkdq$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdccccccc>5555 $Ifgdkd+$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdccccccc>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdcccccdd>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdd d ddd&d'd>5555 $IfgdkdY$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd'd-d.d/d5dWdXd>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdXd^d_d`dgddd>5555 $Ifgdkd͓$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdddddddd>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdddddddd>5555 $IfgdkdA$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdddddd e e>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd eeeee*e+e>5555 $Ifgdkd$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gd+e1e2eIeTeoepe>5555 $Ifgdkdo$$Ifl4rd' 6$ j p t0%644 la $$Ifa$gdpexeyeeeee?6666 $Ifgdkd)$$Iflrd' 6$ j p t0%644 la $$Ifa$gdeeeeeee?6666 $Ifgdkdۘ$$Iflrd' 6$ j p t0%644 la $$Ifa$gdeeeeeeNf?:888$a$kd$$Iflrd' 6$ j p t0%644 la $$Ifa$gdeNfOffffwgxgyggggggggggggggggggggggggghh-0JCJaJmHnHuh0JCJaJjh0JCJUaJ h0Jjh0JUjhpUhp h\hjh0JUh Nffxggggggggggggggggggg$a$h]h&`#$,1h/ =!"#$% ,1h/ =!"#$% $$If!vh#v#v8#v#v:V l  t(0655855/ / ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn$$If!vh#v#v8#v#v:V l t06,55855ap(ytn5$$If!vh#v8#v#v#v:V l  t20658555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ / ap2ytn$$If!vh#v8#v#v#v:V l4 t06++,58555/ ap2ytnC$$If!vh#v#v#v #vj #vp:V l  t20%6,555 5j 5p/ / p2$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p/ $$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l4 t0%6+,555 5j 5p$$If!vh#v#v#v #vj #vp:V l t0%6,555 5j 5p$$If!vh#v#v#v #vj #vp:V l t0%6,555 5j 5p$$If!vh#v#v#v #vj #vp:V l t0%6,555 5j 5p/ ^ 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH :@:  Heading 1$@&5\DA`D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List 4 @4 Footer  !.)@. Page Number44 Header  !>@">  Footnote TextCJaJ@&`1@ Footnote ReferenceH*jCj  Table Grid7:V0H@RH TF0 Balloon TextCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]  ^!FQGUO_2CB_. $$$$$$$$$' /Z29?NRPRwWPZ^aeg478FHI*B.01(1I1i111111232O24KKKKKKKKKKKKKKKKKKKKKKLLLL L#L*L-L4L7L>LKLRLUL]L`LgLjLqLtL{LLLLLLLLLLLLLLLLLLLLLM M MMMM M'M*M1M>MFMIMPMSMZM]MdMgMnM{MMMMMMMMMMMMMMMMMMMMMMMNN NNN#N*N-N4N7N>NJNQNTN[NNNN\OOOO PWPPPPMQZQQQQ RERdRRRRR S&SOS}SSSS-TTT|TTT UWU{UU(WOWxWWW/XSXzXX Y>YjYYYZQZmZZZ[)[H[_[[[[[ \M\y\\\$]c]]]^E^n^^^^4_m____,`^```` a;alaaaabEbvbbbbcOccccd'dXdddd e+epeeeNfg569:;<=>?@ABCDEGJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()+,-./0123456789:;<=>?@AC  '!!8@0(  B S  ?%$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$G??GM%7%7-7377778U;U;];c;fLfLLLLNN]]]]]]]_      !#"$TFLUU,727;7;77788\;b;l;l;qLqLLLLNN]]]]]]]_     !#"$=!!*urn:schemas-microsoft-com:office:smarttags PlaceName=*urn:schemas-microsoft-com:office:smarttags PlaceType9%%*urn:schemas-microsoft-com:office:smarttagsplace8##*urn:schemas-microsoft-com:office:smarttagsdate8$$*urn:schemas-microsoft-com:office:smarttagsCity X 200747DayMonthYear%$#%!!%!!%!!%!!%!!%$%!%$%!!%!IMKPR[`g+49@?F&>EQV22222266%7,777K8O8~99@;E;G;P;U;\;G G^GbGGGGGGG H6HHHHHHHoItIII JJ'J*JGJMJfJnJJJJJJJJJ KK(K0KQKYKKKKKKKL L/L4LVL]L~LLLLkNN*O-OQOUOOOOP PPPP;PAP_PfPPP QQQQR#RRRRRRRSS4S:SQSWSjSpSSSSSSSSSTTTTDTGTITKTpTsTTTTT@UHUUUUU3V;VGVOVVVVVVVWW>WDWvW{WWW]]]]]]R^^^^^_________________` d # #]___________33v##a''(((D)E)d)e)))))-*.*I*J*g*3:>:BCSC]FFDGEGGG H6HLHNHvHxHHHHHHHI8IJ>J1KGKZKuKKKKK L%L5LLL^LsLLL MCMMNPPQQQR$RIRRRTUIUwUUVVVEWmW|WWWWWW X,XXXY;YYY"ZEZZZ,[O[[[5\X\\\]]]]]___________OO]]_________________KZ( ak:FWVqP h^`OJQJo(hHhpp^p`OJQJ^Jo(hHoh@ @ ^@ `OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHhPP^P`OJQJ^Jo(hHoh  ^ `OJQJo(hH^`o()h^`OJQJo(hH pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hH akKZWVq                           %pAJbJXLj k% 2 ?   3 \lT# Sk%-~R8 J"%c)c)/*^#,$,$-TF06152<3D5r73Q9 :x=x@FUA|sAFjG:JfMdnMNLQwwQrRVDTXoXf-^x^NG_Ga,cd=gcj-lplar]tayM~G\QaDX9kL\t>ʍyu7:%丿1^(5(_f籷c 5|S"#TIUX^y n8!Q]]@_@UnknownG*Ax Times New Roman5Symbol3. *Cx ArialA. Arial Narrow5. .[`)Tahoma?= *Cx Courier New;WingdingsA$BCambria Math"1h#f O / O /!4r]r] 2QHX?612!xx $Exeter Partnership NHS Trust Recordsnb259Petrie, Hannah   Oh+'0l   ( 4 @LT\d(Exeter Partnership NHS Trust Recordsnb259NormalPetrie, Hannah2Microsoft Office Word@@jqТ@h9@h9  O՜.+,0  hp  ӣ/r] %Exeter Partnership NHS Trust Records Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry F=9Data EM1Table@WordDocument\SummaryInformation(DocumentSummaryInformation8CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q