{"text_format":"1","workbook":"xlsx","n_sheets":2,"sheets":["申込書","申込者名簿"],"not_rendered":{"charts":0,"images":0,"macros":0,"external_links":0,"defined_names":2,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"申込書","index":0,"n_rows":66,"n_cols":39,"rows_kept":66,"cut":false,"hidden":false,"merged":[[52,1,53,19],[63,1,64,19],[54,2,62,47],[24,6,24,10],[24,11,24,28],[45,9,50,12],[45,6,50,8],[49,13,50,14],[45,13,46,14],[47,13,48,14],[45,27,47,28],[48,27,50,28],[45,29,50,49],[45,22,47,26],[48,22,50,26],[43,0,44,7],[45,0,50,5],[45,15,47,21],[48,15,50,21],[39,6,40,23],[39,0,40,5],[7,1,8,15],[9,1,10,15],[9,16,10,18],[33,6,34,23],[35,6,36,23],[21,0,23,5],[21,6,23,28],[25,6,26,28],[27,0,29,5],[14,0,15,7],[16,0,17,7],[37,0,38,5],[35,0,36,5],[24,0,26,5],[18,29,20,34],[27,29,29,34],[18,6,20,28],[18,0,20,5],[31,0,32,7],[33,24,34,49],[33,0,34,5],[21,35,23,49],[24,35,26,49],[27,35,29,49],[21,29,23,34],[24,29,26,34],[37,6,38,23],[2,0,3,49],[0,0,1,49],[5,41,6,49],[65,2,73,47],[5,36,6,40],[35,24,36,35],[37,24,38,35],[39,24,40,35],[35,38,36,49],[37,38,38,49],[39,38,40,49],[35,36,36,37],[37,36,38,37],[39,36,40,37],[27,6,29,28],[18,35,20,49]]}
["東京都報道事業健康保険組合"]
[]
["平成30年度　インフルエンザワクチン予防接種申込書（出張予防接種用）"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申込日"]
[]
[null,"公益財団法人　　結核予防会"]
[]
[null,"総合健診センター出張健診課",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"宛"]
[]
[]
[null,"以下のとおり、出張によるインフルエンザワクチン予防接種を申込みいたします。"]
[]
["【事業所記入欄】",null,null,null,null,null,null,null,null,null,null,"＝書込み可能セル"]
[]
["１．事業所情報"]
[]
["事 業 所 名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"担当部署名"]
[]
[]
["住　　　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所記号"]
[]
[]
["担 当 者 名",null,null,null,null,null,"(フリガナ)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電 話 番 号"]
[]
[]
["e-mail\nアドレス",null,null,null,null,null,"   @",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"F A X番号"]
[]
[]
[]
["２．接種希望日時"]
[]
[null,null,null,null,null,null,"年月日（曜日）※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"希望接種時間帯　※1."]
[]
["第1希望",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"：",null,null,null,null,null,null,null,null,null,null,null,"～",null,"："]
[]
["第2希望",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"：",null,null,null,null,null,null,null,null,null,null,null,"～",null,"："]
[]
["第3希望",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"：",null,null,null,null,null,null,null,null,null,null,null,"～",null,"："]
[]
["※",null,"土日・祝日は除きます。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※1.",null,"12：00～13：00の時間帯は除きます。"]
[]
["３．接種申込人数"]
[]
["申込人数\n（名簿人数）",null,null,null,null,null,"合計",null,null,{"$f":"W46+W49","v":0},null,null,null,null,null,"被保険者本人",null,null,null,null,null,null,null,null,null,null,null,"人",null,"●被保険者本人負担金　　￥1,200（税込）\n\n●被保険者外　負担金　　￥4,000（税込）※2."]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者外",null,null,null,null,null,null,null,null,null,null,null,"人"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※2.",null,"被保険者外の接種料金は実費分をご負担いただきます。"]
[null,"■■■お申込みの際の注意事項■■■"]
[]
[null,null,"①　出張による予防接種は１００名様を目途にお伺いいたします。\n②　接種希望日の１か月前までにお申し込み下さい。尚、日程調整の都合上、希望接種日以外でご相談させていただく\n　　場合がございます。\n③　予防接種時間は、お申込み人数によってご相談させていただきます。\n④　負担金は予防接種後に会社様へ一括請求いたします。尚、予防接種当日の接種料金の金銭授受は出来ません。\n⑤　個別（個人）の領収証の発行は致し兼ねますことをご了承下さい。"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"■■■予防接種時の注意事項■■■"]
[]
[null,null,"①　会議室等の独立した予防接種会場を必ずご用意ください。\n②　予防接種用、診察用等のテーブルおよび椅子をご用意ください。設営は当方で行います。\n③　予診票は裏面の注意事項を熟読し事前に記入し接種会場へお持ち下さい。尚、体温は接種直前に測定します。\n④　予防接種前の受付の際には、必ず「健康保険被保険者証」をご提示下さい。\n⑤　１６歳未満の方の接種はお受けいたしません。（小児科医の判断が必要な為）\n⑥　当日の予診結果により、予防接種をお断りする場合がございます。（既往歴、発熱等）"]

{"sheet":"申込者名簿","index":1,"n_rows":35,"n_cols":43,"rows_kept":35,"cut":false,"hidden":false,"merged":[[4,42,4,47],[2,0,2,4],[3,0,3,4],[2,5,2,23],[5,33,5,41],[4,0,4,1],[4,2,4,6],[4,7,4,17],[4,18,4,28],[4,29,4,30],[4,31,4,32],[3,29,3,47],[5,42,5,47],[2,29,2,47],[5,18,5,28],[5,7,5,17],[5,0,5,1],[5,2,5,6],[2,24,2,28],[3,5,3,23],[3,24,3,28],[4,33,4,41],[5,29,5,30],[5,31,5,32],[6,42,6,47],[7,0,7,1],[7,2,7,6],[7,7,7,17],[7,18,7,28],[7,29,7,30],[7,31,7,32],[7,33,7,41],[7,42,7,47],[6,0,6,1],[6,2,6,6],[6,7,6,17],[6,18,6,28],[6,29,6,30],[6,31,6,32],[6,33,6,41],[8,33,8,41],[8,42,8,47],[9,0,9,1],[9,2,9,6],[9,7,9,17],[9,18,9,28],[9,29,9,30],[9,31,9,32],[9,33,9,41],[9,42,9,47],[8,0,8,1],[8,2,8,6],[8,7,8,17],[8,18,8,28],[8,29,8,30],[8,31,8,32],[10,33,10,41],[10,42,10,47],[11,0,11,1],[11,2,11,6],[11,7,11,17],[11,18,11,28],[11,29,11,30],[11,31,11,32],[11,33,11,41],[11,42,11,47],[10,0,10,1],[10,2,10,6],[10,7,10,17],[10,18,10,28],[10,29,10,30],[10,31,10,32],[12,33,12,41],[12,42,12,47],[13,0,13,1],[13,2,13,6],[13,7,13,17],[13,18,13,28],[13,29,13,30],[13,31,13,32],[13,33,13,41],[13,42,13,47],[12,0,12,1],[12,2,12,6],[12,7,12,17],[12,18,12,28],[12,29,12,30],[12,31,12,32],[14,33,14,41],[14,42,14,47],[15,0,15,1],[15,2,15,6],[15,7,15,17],[15,18,15,28],[15,29,15,30],[15,31,15,32],[15,33,15,41],[15,42,15,47],[14,0,14,1],[14,2,14,6],[14,7,14,17],[14,18,14,28],[14,29,14,30],[14,31,14,32],[16,33,16,41],[16,42,16,47],[17,0,17,1],[17,2,17,6],[17,7,17,17],[17,18,17,28],[17,29,17,30],[17,31,17,32],[17,33,17,41],[17,42,17,47],[16,0,16,1],[16,2,16,6],[16,7,16,17],[16,18,16,28],[16,29,16,30],[16,31,16,32],[18,33,18,41],[18,42,18,47],[19,0,19,1],[19,2,19,6],[19,7,19,17],[19,18,19,28],[19,29,19,30],[19,31,19,32],[19,33,19,41],[19,42,19,47],[18,0,18,1],[18,2,18,6],[18,7,18,17],[18,18,18,28],[18,29,18,30],[18,31,18,32],[20,33,20,41],[20,42,20,47],[21,0,21,1],[21,2,21,6],[21,7,21,17],[21,18,21,28],[21,29,21,30],[21,31,21,32],[21,33,21,41],[21,42,21,47],[20,0,20,1],[20,2,20,6],[20,7,20,17],[20,18,20,28],[20,29,20,30],[20,31,20,32],[22,33,22,41],[22,42,22,47],[23,0,23,1],[23,2,23,6],[23,7,23,17],[23,18,23,28],[23,29,23,30],[23,31,23,32],[23,33,23,41],[23,42,23,47],[22,0,22,1],[22,2,22,6],[22,7,22,17],[22,18,22,28],[22,29,22,30],[22,31,22,32],[24,33,24,41],[24,42,24,47],[25,0,25,1],[25,2,25,6],[25,7,25,17],[25,18,25,28],[25,29,25,30],[25,31,25,32],[25,33,25,41],[25,42,25,47],[24,0,24,1],[24,2,24,6],[24,7,24,17],[24,18,24,28],[24,29,24,30],[24,31,24,32],[26,33,26,41],[26,42,26,47],[27,0,27,1],[27,2,27,6],[27,7,27,17],[27,18,27,28],[27,29,27,30],[27,31,27,32],[27,33,27,41],[27,42,27,47],[26,0,26,1],[26,2,26,6],[26,7,26,17],[26,18,26,28],[26,29,26,30],[26,31,26,32],[28,33,28,41],[28,42,28,47],[29,0,29,1],[29,2,29,6],[29,7,29,17],[29,18,29,28],[29,29,29,30],[29,31,29,32],[29,33,29,41],[29,42,29,47],[28,0,28,1],[28,2,28,6],[28,7,28,17],[28,18,28,28],[28,29,28,30],[28,31,28,32],[30,33,30,41],[30,42,30,47],[31,0,31,1],[31,2,31,6],[31,7,31,17],[31,18,31,28],[31,29,31,30],[31,31,31,32],[31,33,31,41],[31,42,31,47],[30,0,30,1],[30,2,30,6],[30,7,30,17],[30,18,30,28],[30,29,30,30],[30,31,30,32],[34,33,34,41],[34,42,34,47],[34,0,34,1],[34,2,34,6],[34,7,34,17],[34,18,34,28],[34,29,34,30],[34,31,34,32],[32,33,32,41],[32,42,32,47],[33,0,33,1],[33,2,33,6],[33,7,33,17],[33,18,33,28],[33,29,33,30],[33,31,33,32],[33,33,33,41],[33,42,33,47],[32,0,32,1],[32,2,32,6],[32,7,32,17],[32,18,32,28],[32,29,32,30],[32,31,32,32]]}
["平成30年度　インフルエンザワクチン予防接種申込者名簿（出張予防接種用）"]
["(必要に応じてコピーしてお使い下さい）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"＝書込み可能セル"]
["事業所名",null,null,null,null,{"$f":"申込書!G19","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記　号",null,null,null,null,{"$f":"申込書!AJ22","v":0}]
["接種日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"健保名",null,null,null,null,"東京都報道事業健康保険組合"]
["№",null,"保険証番号",null,null,null,null,"漢字氏名",null,null,null,null,null,null,null,null,null,null,"ｶﾅ氏名（半角）",null,null,null,null,null,null,null,null,null,null,"性別",null,"続柄",null,"生年月日",null,null,null,null,null,null,null,null,"備考"]
[1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[{"$f":"A6+1","v":2},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[{"$f":"A7+1","v":3},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[4,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[6,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[7,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[8,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[9,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[10,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[11,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[12,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[13,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[14,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[15,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[16,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[17,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[18,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[19,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[20,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[21,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[22,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[23,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[24,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[25,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[26,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[27,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[28,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[29,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]
[30,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人"]