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{"sheet":"【請求書様式】","index":0,"n_rows":39,"n_cols":12,"rows_kept":39,"cut":false,"hidden":false,"merged":[[1,1,1,6],[38,1,38,7],[34,4,34,7],[35,1,37,3],[35,4,35,7],[36,4,36,7],[37,4,37,7],[16,1,16,11],[28,1,34,3],[28,4,28,7],[31,4,31,7],[29,4,29,7],[30,4,30,7],[23,1,23,3],[22,1,22,3],[21,1,21,3],[22,4,22,7],[21,4,21,7],[22,9,22,10],[21,9,21,10],[20,1,20,10],[33,4,33,7],[23,4,23,7],[23,9,23,10],[25,1,25,3],[25,4,25,10],[24,4,24,10],[32,4,32,7],[24,1,24,3]]}
[]
[null,"秦野市長　あて",null,null,null,null,null,null,null,"請求年月日",{"$f":"医療機関入力シート!D3","v":"令和７年　月　日"}]
[]
[null,null,null,null,null,null,null,null,"〇請求者"]
[null,null,null,null,null,null,null,null,"住　　　所",{"$f":"医療機関入力シート!D4","v":0}]
[null,null,null,null,null,null,null,null,"医療機関名",{"$f":"医療機関入力シート!D5","v":0}]
[null,null,null,null,null,null,null,null,"代表者氏名",{"$f":"医療機関入力シート!D6","v":0},null,"㊞"]
[null,null,null,null,null,null,null,null,"電　話",{"$f":"医療機関入力シート!D7","v":0}]
[]
[null,null,null,null,null,null,null,null,"〇当請求における責任者・担当者記入欄"]
[null,null,null,null,null,null,null,null,"責任者氏名",{"$f":"医療機関入力シート!D8","v":0}]
[null,null,null,null,null,null,null,null,"電　話",{"$f":"医療機関入力シート!D9","v":0}]
[null,null,null,null,null,null,null,null,"担当者氏名",{"$f":"医療機関入力シート!D10","v":0}]
[null,null,null,null,null,null,null,null,"電　話",{"$f":"医療機関入力シート!D11","v":0}]
[]
[]
[null,"風しん対策　請求書"]
[]
[null,null,null,null,null,null,null,"請求額","￥",{"$f":"SUM(K39)","v":0},"円"]
[]
[null,"風しんの追加的対策に係る費用の支払については、次の名義の預金口座に口座振替されるよう依頼します。"]
[null,"（金融コード）",null,null,{"$f":"医療機関入力シート!D12","v":0},null,null,null,"（支店名コード）",{"$f":"医療機関入力シート!D14","v":0}]
[null,"振込先",null,null,{"$f":"医療機関入力シート!D13","v":0},null,null,null,"支店名",{"$f":"医療機関入力シート!D15","v":0}]
[null,"預金種目",null,null,{"$f":"医療機関入力シート!D16","v":0},null,null,null,"口座番号",{"$f":"医療機関入力シート!D17","v":0}]
[null,"（フリガナ）",null,null,{"$f":"医療機関入力シート!D18","v":0}]
[null,"口座名義人",null,null,{"$f":"医療機関入力シート!D19","v":0}]
[]
[null,null,null,null,null,null,null,null,"請求件数","税込単価","請求金額\n（税込）"]
[null,"抗体検査",null,null,"①健診・HI法",null,null,null,null,1419,{"$f":"I29*J29","v":0}]
[null,null,null,null,"②健診・EIA法",null,null,null,null,2948,{"$f":"I30*J30","v":0}]
[null,null,null,null,"③HI法",null,null,null,null,5423,0]
[null,null,null,null,"④EIA法",null,null,null,null,6952,0]
[null,null,null,null,"⑤夜間休日・HI法",null,null,null,null,5973,0]
[null,null,null,null,"⑥夜間休日・EIA法",null,null,null,null,7502,0]
[null,null,null,null,"小計",null,null,null,{"$f":"SUM(I29:I34)","v":0},null,{"$f":"SUM(K29:K34)","v":0}]
[null,"予防接種",null,null,"通常",null,null,null,null,11022,{"$f":"I36*J36","v":0}]
[null,null,null,null,"予診のみ",null,null,null,null,3201,{"$f":"I37*J37","v":0}]
[null,null,null,null,"小計",null,null,null,{"$f":"SUM(I36:I37)","v":0},null,{"$f":"SUM(K36:K37)","v":0}]
[null,"合計",null,null,null,null,null,null,{"$f":"SUM(I38,I35)","v":0},null,{"$f":"K38+K35","v":0}]

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[]
[null,null,"医療機関入力欄"]
[null,null,"請求年月日","令和７年　月　日",null,"見本","請求年月日","令和７年４月１日"]
[null,null,"請求者住所",null,null,null,"請求者住所","神奈川県秦野市緑町１－１"]
[null,null,"請求者医療機関名",null,null,null,"請求者医療機関名","秦野緑町クリニック"]
[null,null,"請求者代表者氏名",null,null,null,"請求者代表者氏名","緑町　太郎"]
[null,null,"請求者電話番号",null,null,null,"請求者電話番号","0463-00-0000"]
[null,null,"（※）責任者氏名",null,null,null,"責任者氏名","保健　花子"]
[null,null,"（※）責任者電話番号",null,null,null,"責任者電話番号","0463-11-0000"]
[null,null,"（※）担当者氏名",null,null,null,"担当者氏名","接種　次郎"]
[null,null,"（※）担当者電話番号",null,null,null,"担当者電話番号","0463-11-XXXX"]
[null,null,"金融コード",null,null,null,"金融コード","1234"]
[null,null,"振込先",null,null,null,"振込先","秦野銀行"]
[null,null,"支店名コード",null,null,null,"支店名コード","001"]
[null,null,"支店名",null,null,null,"支店名","本店営業部"]
[null,null,"預金種目",null,null,null,"預金種目","普通"]
[null,null,"口座番号",null,null,null,"口座番号","1234567"]
[null,null,"フリガナ",null,null,null,"フリガナ","ミドリチョウ　タロウ"]
[null,null,"口座名義人",null,null,null,"口座名義人","緑町　太郎"]
[]
[null,null,"【入力時の注意事項】"]
[null,null,"（※）責任者及び担当者の入力欄においては、代表者印の押印によって省略できます。"]
[]
[]
[]
[]
[null,null,null,1290]
[null,null,null,2680]
[null,null,null,4930]
[null,null,null,6320]
[null,null,null,5430]
[null,null,null,6820]