, ,"年月日", "姓名",,
"性别", "身份证号码",,
"年龄", "工种",,
"有无违法违规行为", "所属企业(或培训机构)名称",,
, "培训学时","年月日至年月日,共16学时",,
"培训内容(科目教材名称)考试成绩","《建筑施工特种作业人员安全技术考核培训教材》工种()()考试成绩(分)",,
"本人签字",,
"加盖企业或培训机构公章",