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[null,"2026年度　全国健康保険協会管掌　生活習慣病予防健診申込書　",null,null,null,null,null,null,null,null,null,"（病院予約専用用紙）",null,null,{"$f":"IF(F9=\"\",\"\",F9)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NO.１"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※病院使用欄"]
[null,null,"下記必要事項をご入力（ご記入）いただき、予約フォームに添付してお送り下さい",null,null,null,null,null,null,null,null,"（1ヶ月先からのご予約となります）"]
[null,"※","申込みが確認出来次第、こちらからお電話いたしますのでしばらくお待ちください",null,null,null,null,null,null,null,null,"※この健診は被保険者（本人）の方が"]
[null,null,null,null,null,null,null,null,null,null,null,"　対象となります"]
[null,"フリガナ\n①事業所",null,null,null,null,null,null,null,null,null,"フリガナ\n② 支店名（営業所名）"]
[]
[null,"所在地（任継は自宅）",null,null,null,"〒",null,null,null,null,null,"所在地",null,"〒"]
[]
[]
[null,"電話番号",null,null,null,null,null,"FAX",null,null,null,"電話番号",null,null,null,null,"FAX"]
[null,"ご担当者",null,null,null,null,null,null,null,null,null,"ご担当者"]
[null,"資格確認書保険者番号",null,null,null,null,null,null,null,null,null,"※左記と連絡先が別の場合（支店・営業所）はこちらにご記入ください"]
[null,"資格確認書記号"]
[null,"案内・結果の郵送先"]
[]
[null,"※","案内・結果は個別封筒に封入し全て①又は②のいずれかに送付致します。（受診者様自宅への配送は不可）"]
[null,"※","事前の案内は、順次発送致します。受診日の２週間前に届いていない場合は、ご連絡ください。"]
[null,"※","全ての検査は、毎月・平日（土日祝除く）の午前中に実施です。（日程が変更する場合もございます）"]
[null,"※","乳がん検診（月）（木）受診できません。",null,null,null,null,null,null,null,null,null,"<受付・お問合せ>  平日１３時～１６時"]
[null,"※","マイナンバーカードしかお持ちでない方で、資格確認書の記号・番号の確認が出来ない方は、資格確認書の記入は不要です。",null,null,null,null,null,null,null,null,null,"          TEL：0725-41-1331　/　FAX：0725-51-7287"]
[null,"※","お支払いは、当日個別でのお支払いとなります。（請求書対応不可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和泉市立総合医療センター　健診センター（土日祝休）"]
[null,"※","健診当日の内容変更・追加は出来ません。必ず2週間前までにお電話をお願いします。",null,null,null,null,null,null,null,null,null,"                            〒594-0073　和泉市和気町4丁目5番1号"]
[null,"　　",null,null,null,null,null,null,null,null,null,null,"健診機関コード（2710503612）"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(生活習慣病予防健診申込書①!O1=\"\",\"\",生活習慣病予防健診申込書①!O1)","v":""},null,null,null,null,null,null,null,"今日の日付","2026-02-24",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IF(AND(AN8=\"受診OK\",C9=\"女\"),AO4:AO5,)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1月","1日","元年","元年","元年"]
["2026年度　全国健康保険協会管掌",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No.2",null,null,null,"NO.２",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"付加検診",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2月","2日","2年","2年","2年"]
["生活習慣病予防健診申込書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和泉市立総合医療センター健診センター",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"選択肢",null,null,null,"胃の検査　なし",{"$f":"S10","v":0},{"$f":"S16","v":0},{"$f":"S22","v":0},{"$f":"S28","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3月","3日","3年","3年","3年"]
[null,null,null,null,null,null,null,null,null,"●喀痰細胞診検査（任意）50歳以上で喫煙指数が600以上の方が対象となります。\n・喀痰をお申込みされる方は※1をご確認下さい。\n・2026年度より、35～39歳の方は胃・大腸検査が省略可能の為、お申し出下さい。\n省略される方は下記チェック欄に〇を付けて下さい。（※2）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4月","4日","4年","4年","4年"]
["受診者リスト ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX：0725-51-7287",null,null,null,null,null,null,null,null,"生年月日",null,"希望日",null,null,null,null,null,null,null,null,null,null,null,"有・無","有・無",null,null,null,{"$f":"S11","v":0},{"$f":"S17","v":0},{"$f":"S23","v":0},{"$f":"S29","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5月","5日","5年","5年","5年"]
["申込が確認出来次第、こちらからお電話いたしますのでしばらくお待ちください。",null,null,null,null,null,null,null,null,"●胃カメラ検査：4,400円（税込）追加　鎮静剤：1,100円（税込）追加\n・一般健診項目は、どの項目もすべて受診していただくようになっています。\n・節目健診の肺機能検査は、協会けんぽの通達により未実施とすることがあります。\n・肝炎ウィルス検査は、過去にC型肝炎検査を受けたことがある方は受診出来ません。\n※乳がん検診は妊娠中、授乳中（断乳後6か月以内）、豊胸手術（脂肪注入含む）後、\nペースメーカーやCVポート等を装着中、VPシャントを施工中の方は受診出来ません。",null,null,null,null,null,null,null,null,null,null,null,"病院使用欄",null,null,"病院使用欄",null,null,null,null,null,"昭和","平成","月","日付",null,null,null,null,null,null,null,null,"年齢","一般検診","有","有","○",null,null,{"$f":"S12","v":"鎮静剤"},{"$f":"S18","v":"鎮静剤"},{"$f":"S24","v":"鎮静剤"},{"$f":"S30","v":"鎮静剤"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"6月","6日","6年","6年","6年"]
["フリガナは資格確認書に印字の文字と完全一致で入力をお願いします。\n※患者IDは当院の診察券番号または、過去の健診結果に記載されているカルテ番号をご入力ください。\n任意継続の方は、下記任意継続の欄に○を付けて下さい。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=40,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"64年","1年","4月","1日","元年","①","年齢",{"$f":"E10&F10&E12&F12","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E10)=\"令和\",2018,IF(TRIM(E10)=\"平成\",1988,IF(TRIM(E10)=\"昭和\",1925,0)))+IF(TRIM(F10)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F10),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E12),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F12),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN7,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BK24:BK64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},"無","無",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,"7月","7日","7年","7年","7年"]
["資格確認書\n番号","患者ID\n（診察券番号）","姓（フリガナ）\n名（フリガナ）","性別","生年月日",null,"自宅住所",null,"受診コース（協会けんぽ補助対象）\n○を入力してください",null,null,null,null,null,null,null,null,"バリウム","胃カメラ","35～39歳\n（※2）",null,"希望日","月","日","病院使用欄",null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=20,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"63年","2年","5月","2日","2年",null,"子宮頸がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AL9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AP9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BD24:BD30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"8月","8日","8年","8年","8年"]
[null,null,"氏　名",null,"元号","年","〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),OR(AQ7=40,AQ7=45,AQ7=50,AQ7=55,AQ7=60,AQ7=65,AQ7=70)),\"OK\",\"NG\"),\"NG\")","v":"NG"},"62年","3年","6月","3日","3年",null,null,{"$f":"IF(COUNTIF(AN32:AN51,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,null,{"$f":"IF(COUNTIF(AV24:AV53,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,"子宮頸がん（単独）",{"$f":"IF(COUNTIF(AN24:AN33,\"〇\"),\"受診OK\",\"受診NG\")","v":"受診NG"},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AT9=\"受診OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"9月","9日","9年","9年","9年"]
[null,null,null,null,null,null,null,null,"一般","若年\n一般","子宮頸がん\n（単独）","節目","乳がん","子宮頸がん","骨粗鬆症","肝炎ウィルス","喀痰細胞診\n（※1）",null,null,"胃なし","大腸なし","①",null,null,"ＩＤ",null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=40,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"61年","4年","7月","4日","4年","②","年齢",{"$f":"E16&F16&E18&F18","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E16)=\"令和\",2018,IF(TRIM(E16)=\"平成\",1988,IF(TRIM(E16)=\"昭和\",1925,0)))+IF(TRIM(F16)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F16),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E18),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F18),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN10,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BL24:BL64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},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,"10月","10日","10年","10年","10年"]
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[null,null,"氏　名",null,"元号","年","〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"44年","21年",null,"21日",null,null,"26歳","2000-04-02","2001-04-01","×","×","×","×",null,"46歳","1979-04-02","1980-04-01","×","×","×","×",null,"55歳","1971-04-02","1972-04-01","×","×","×","×","38歳","1988-04-02","1989-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,"27日","27年","27年"]
[null,null,null,null,null,null,null,null,"一般","若年\n一般","子宮頸がん\n（単独）","節目","乳がん","子宮頸がん","骨粗鬆症","肝炎ウィルス","喀痰細胞診\n（※1）",null,null,"胃なし","大腸なし","①",null,null,"ＩＤ",null,null,null,null,null,"43年","22年",null,"22日",null,null,"28歳","1998-04-02","1999-04-01","×","×","×","×",null,"48歳","1977-04-02","1978-04-01","×","×","×","×",null,"60歳","1966-04-02","1967-04-01","×","×","×","×","39歳","1987-04-02","1988-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,"28日","28年","28年"]
[null,null,null,null,"月","日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"42年","23年",null,"23日",null,null,"30歳","1996-04-02","1997-04-01","×","×","×","×",null,"50歳","1975-04-02","1976-04-01","×","×","×","×",null,"65歳","1961-04-02","1962-04-01","×","×","×","×","40歳","1986-04-02","1987-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,"29日","29年","29年"]
["任意継続",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鎮静剤",null,null,"②",null,null,"日程連絡",null,null,null,null,null,"41年","24年",null,"24日",null,null,"32歳","1994-04-02","1995-04-01","×","×","×","×",null,"52歳","1973-04-02","1974-04-01","×","×","×","×",null,"70歳","1956-04-02","1957-04-01","×","×","×","×","41歳","1985-04-02","1986-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,"30日","30年","30年"]
[null,null,null,null,"TEL：",null,null,null,null,null,null,null,null,null,null,null,null,null,"有・無",null,null,null,null,null,null,null,null,null,null,null,"40年","25年",null,"25日",null,null,"34歳","1992-04-02","1993-04-01","×","×","×","×",null,"54歳","1971-04-02","1972-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"42歳","1984-04-02","1985-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,"31日","31年","31年"]
[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,"39年","26年",null,"26日",null,null,"36歳","1990-04-02","1991-04-01","×","×","×","×",null,"56歳","1969-04-02","1970-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"43歳","1983-04-02","1984-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"32年"]
[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,"38年","27年",null,"27日",null,null,"38歳","1988-04-02","1989-04-01","×","×","×","×",null,"58歳","1967-04-02","1968-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"44歳","1982-04-02","1983-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"33年"]
[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,"37年","28年",null,"28日",null,null,"40歳","1986-04-02","1987-04-01","×","×","×","×",null,"60歳","1965-04-02","1966-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"45歳","1981-04-02","1982-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"34年"]
[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,"36年","29年",null,"29日",null,null,"42歳","1984-04-02","1985-04-01","×","×","×","×",null,"62歳","1963-04-02","1964-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"46歳","1980-04-02","1981-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"35年"]
[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,"35年","30年",null,"30日",null,null,"44歳","1982-04-02","1983-04-01","×","×","×","×",null,"64歳","1961-04-02","1962-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"47歳","1979-04-02","1980-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"36年"]
[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,"34年","31年",null,"31日",null,null,"46歳","1980-04-02","1981-04-01","×","×","×","×",null,"66歳","1959-04-02","1960-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"37年"]
[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,"33年",null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×","×",null,"68歳","1957-04-02","1958-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"49歳","1977-04-02","1978-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"38年"]
[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,"32年",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×","×",null,"70歳","1955-04-02","1956-04-01","×","×","×","×",null,null,"子宮頸がん（単独）",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"39年"]
[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,"31年",null,null,null,null,null,"52歳","1974-04-02","1975-04-01","×","×","×","×",null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,36,"1989-04-02","1990-04-01",{"$f":"IF(AND($AN$7>=BB40,$AN$7<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB40,$AN$10<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB40,$AN$13<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB40,$AN$16<=BC40),\"〇\",\"×\")","v":"×"},"51歳","1975-04-02","1976-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"40年"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30年",null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×","×",null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,38,"1987-04-02","1988-04-01",{"$f":"IF(AND($AN$7>=BB41,$AN$7<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB41,$AN$10<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB41,$AN$13<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB41,$AN$16<=BC41),\"〇\",\"×\")","v":"×"},"52歳","1974-04-02","1975-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"41年"]
[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,"29年",null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×","×",null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"53歳","1973-04-02","1974-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"42年"]
[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,"28年",null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×","×",null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"43年"]
[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,"27年",null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×","×",null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"55歳","1971-04-02","1972-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"44年"]
[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,"26年",null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×","×",null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"45年"]
[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,"25年",null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×","×",null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"57歳","1969-04-02","1970-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"46年"]
[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,"24年",null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×","×",null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"47年"]
[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,"23年",null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×","×",null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"59歳","1967-04-02","1968-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"48年"]
[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,"22年",null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×","×",null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"49年"]
[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,"21年",null,null,null,null,null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"61歳","1965-04-02","1966-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"50年"]
[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,"20年",null,null,null,null,null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"51年"]
[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,"19年",null,null,null,null,null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"63歳","1963-04-02","1964-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"52年"]
[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,"18年",null,null,null,null,null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"53年"]
[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,"17年",null,null,null,null,null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"65歳","1961-04-02","1962-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"54年"]
[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,"16年",null,null,null,null,null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"55年"]
[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,"15年",null,null,null,null,null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"67歳","1959-04-02","1960-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"56年"]
[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,"14年",null,null,null,null,null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"57年"]
[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,"13年",null,null,null,null,null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"69歳","1957-04-02","1958-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"58年"]
[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,"12年",null,null,null,null,null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"59年"]
[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,"11年",null,null,null,null,null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"71歳","1955-04-02","1956-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"60年"]
[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,"10年",null,null,null,null,null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"72歳","1954-04-02","1955-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"61年"]
[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,"9年",null,null,null,null,null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"73歳","1953-04-02","1954-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"62年"]
[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,"8年",null,null,null,null,null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"74歳","1952-04-02","1953-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"63年"]
[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,"7年",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,"75歳","1951-04-02","1952-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"64年"]
[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,"6年"]
[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,"5年"]
[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,"4年"]
[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,"3年"]
[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,"2年"]
[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,"1年"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(生活習慣病予防健診申込書①!O1=\"\",\"\",生活習慣病予防健診申込書①!O1)","v":""},null,null,null,null,null,null,null,"今日の日付","2026-02-25",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IF(AND(AN8=\"受診OK\",C9=\"女\"),AO4:AO5,)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1月","1日","元年","元年","元年"]
["2026年度　全国健康保険協会管掌",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No.2",null,null,null,"NO.２",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"付加検診",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2月","2日","2年","2年","2年"]
["生活習慣病予防健診申込書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和泉市立総合医療センター健診センター",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"選択肢",null,null,null,"胃の検査　なし",{"$f":"S10","v":0},{"$f":"S16","v":0},{"$f":"S22","v":0},{"$f":"S28","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3月","3日","3年","3年","3年"]
[null,null,null,null,null,null,null,null,null,"●喀痰細胞診検査（任意）50歳以上で喫煙指数が600以上の方が対象となります。\n・喀痰をお申込みされる方は※1をご確認下さい。\n・2026年度より、35～39歳の方は胃・大腸検査が省略可能の為、お申し出下さい。\n省略される方は下記チェック欄に〇を付けて下さい。（※2）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4月","4日","4年","4年","4年"]
["受診者リスト ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX：0725-51-7287",null,null,null,null,null,null,null,null,"生年月日",null,"希望日",null,null,null,null,null,null,null,null,null,null,null,"有・無","有・無",null,null,null,{"$f":"S11","v":0},{"$f":"S17","v":0},{"$f":"S23","v":0},{"$f":"S29","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5月","5日","5年","5年","5年"]
["申込が確認出来次第、こちらからお電話いたしますのでしばらくお待ちください。",null,null,null,null,null,null,null,null,"●胃カメラ検査：4,400円（税込）追加　鎮静剤：1,100円（税込）追加\n・一般健診項目は、どの項目もすべて受診していただくようになっています。\n・節目健診の肺機能検査は、協会けんぽの通達により未実施とすることがあります。\n・肝炎ウィルス検査は、過去にC型肝炎検査を受けたことがある方は受診出来ません。\n※乳がん検診は妊娠中、授乳中（断乳後6か月以内）、豊胸手術（脂肪注入含む）後、\nペースメーカーやCVポート等を装着中、VPシャントを施工中の方は受診出来ません。",null,null,null,null,null,null,null,null,null,null,null,"病院使用欄",null,null,"病院使用欄",null,null,null,null,null,"昭和","平成","月","日付",null,null,null,null,null,null,null,null,"年齢","一般検診","有","有","○",null,null,{"$f":"S12","v":"鎮静剤"},{"$f":"S18","v":"鎮静剤"},{"$f":"S24","v":"鎮静剤"},{"$f":"S30","v":"鎮静剤"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"6月","6日","6年","6年","6年"]
["フリガナは資格確認書に印字の文字と完全一致で入力をお願いします。\n※患者IDは当院の診察券番号または、過去の健診結果に記載されているカルテ番号をご入力ください。\n任意継続の方は、下記任意継続の欄に○を付けて下さい。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=40,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"64年","1年","4月","1日","元年","①","年齢",{"$f":"E10&F10&E12&F12","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E10)=\"令和\",2018,IF(TRIM(E10)=\"平成\",1988,IF(TRIM(E10)=\"昭和\",1925,0)))+IF(TRIM(F10)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F10),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E12),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F12),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN7,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BK24:BK64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},"無","無",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,"7月","7日","7年","7年","7年"]
["資格確認書\n番号","患者ID\n（診察券番号）","姓（フリガナ）\n名（フリガナ）","性別","生年月日",null,"自宅住所",null,"受診コース（協会けんぽ補助対象）\n○を入力してください",null,null,null,null,null,null,null,null,"バリウム","胃カメラ","35～39歳\n（※2）",null,"希望日","月","日","病院使用欄",null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=20,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"63年","2年","5月","2日","2年",null,"子宮頸がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AL9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AP9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BD24:BD30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"8月","8日","8年","8年","8年"]
[null,null,"氏　名",null,"元号","年","〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),OR(AQ7=40,AQ7=45,AQ7=50,AQ7=55,AQ7=60,AQ7=65,AQ7=70)),\"OK\",\"NG\"),\"NG\")","v":"NG"},"62年","3年","6月","3日","3年",null,null,{"$f":"IF(COUNTIF(AN32:AN51,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,null,{"$f":"IF(COUNTIF(AV24:AV53,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,"子宮頸がん（単独）",{"$f":"IF(COUNTIF(AN24:AN33,\"〇\"),\"受診OK\",\"受診NG\")","v":"受診NG"},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AT9=\"受診OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"9月","9日","9年","9年","9年"]
[null,null,null,null,null,null,null,null,"一般","若年\n一般","子宮頸がん\n（単独）","節目","乳がん","子宮頸がん","骨粗鬆症","肝炎ウィルス","喀痰細胞診\n（※1）",null,null,"胃なし","大腸なし","①",null,null,"ＩＤ",null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=40,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"61年","4年","7月","4日","4年","②","年齢",{"$f":"E16&F16&E18&F18","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E16)=\"令和\",2018,IF(TRIM(E16)=\"平成\",1988,IF(TRIM(E16)=\"昭和\",1925,0)))+IF(TRIM(F16)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F16),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E18),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F18),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN10,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BL24:BL64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},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,"10月","10日","10年","10年","10年"]
[null,null,null,null,"月","日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=20,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"60年","5年","8月","5日","5年",null,"子宮頸がん",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(AND(AL12=\"年齢OK\",D16=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(AND(AP12=\"年齢OK\",D16=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BE24:BE30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"11月","11日","11年","11年","11年"]
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[null,null,null,null,"TEL：",null,null,null,null,null,null,null,null,null,null,null,null,null,"有・無",null,null,null,null,null,null,null,null,null,null,null,"40年","25年",null,"25日",null,null,"34歳","1992-04-02","1993-04-01","×","×","×","×",null,"54歳","1971-04-02","1972-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"42歳","1984-04-02","1985-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,"31日","31年","31年"]
[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,"39年","26年",null,"26日",null,null,"36歳","1990-04-02","1991-04-01","×","×","×","×",null,"56歳","1969-04-02","1970-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"43歳","1983-04-02","1984-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"32年"]
[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,"38年","27年",null,"27日",null,null,"38歳","1988-04-02","1989-04-01","×","×","×","×",null,"58歳","1967-04-02","1968-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"44歳","1982-04-02","1983-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"33年"]
[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,"37年","28年",null,"28日",null,null,"40歳","1986-04-02","1987-04-01","×","×","×","×",null,"60歳","1965-04-02","1966-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"45歳","1981-04-02","1982-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"34年"]
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[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,"34年","31年",null,"31日",null,null,"46歳","1980-04-02","1981-04-01","×","×","×","×",null,"66歳","1959-04-02","1960-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"37年"]
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[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,"32年",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×","×",null,"70歳","1955-04-02","1956-04-01","×","×","×","×",null,null,"子宮頸がん（単独）",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"39年"]
[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,"31年",null,null,null,null,null,"52歳","1974-04-02","1975-04-01","×","×","×","×",null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,36,"1989-04-02","1990-04-01",{"$f":"IF(AND($AN$7>=BB40,$AN$7<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB40,$AN$10<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB40,$AN$13<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB40,$AN$16<=BC40),\"〇\",\"×\")","v":"×"},"51歳","1975-04-02","1976-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"40年"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30年",null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×","×",null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,38,"1987-04-02","1988-04-01",{"$f":"IF(AND($AN$7>=BB41,$AN$7<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB41,$AN$10<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB41,$AN$13<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB41,$AN$16<=BC41),\"〇\",\"×\")","v":"×"},"52歳","1974-04-02","1975-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"41年"]
[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,"29年",null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×","×",null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"53歳","1973-04-02","1974-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"42年"]
[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,"28年",null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×","×",null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"43年"]
[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,"27年",null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×","×",null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"55歳","1971-04-02","1972-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"44年"]
[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,"26年",null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×","×",null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"45年"]
[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,"25年",null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×","×",null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"57歳","1969-04-02","1970-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"46年"]
[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,"24年",null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×","×",null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"47年"]
[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,"23年",null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×","×",null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"59歳","1967-04-02","1968-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"48年"]
[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,"22年",null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×","×",null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"49年"]
[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,"21年",null,null,null,null,null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"61歳","1965-04-02","1966-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"50年"]
[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,"20年",null,null,null,null,null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"51年"]
[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,"19年",null,null,null,null,null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"63歳","1963-04-02","1964-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"52年"]
[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,"18年",null,null,null,null,null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"53年"]
[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,"17年",null,null,null,null,null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"65歳","1961-04-02","1962-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"54年"]
[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,"16年",null,null,null,null,null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"55年"]
[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,"15年",null,null,null,null,null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"67歳","1959-04-02","1960-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"56年"]
[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,"14年",null,null,null,null,null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"57年"]
[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,"13年",null,null,null,null,null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"69歳","1957-04-02","1958-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"58年"]
[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,"12年",null,null,null,null,null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"59年"]
[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,"11年",null,null,null,null,null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"71歳","1955-04-02","1956-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"60年"]
[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,"10年",null,null,null,null,null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"72歳","1954-04-02","1955-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"61年"]
[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,"9年",null,null,null,null,null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"73歳","1953-04-02","1954-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"62年"]
[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,"8年",null,null,null,null,null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"74歳","1952-04-02","1953-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"63年"]
[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,"7年",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,"75歳","1951-04-02","1952-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"64年"]
[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,"6年"]
[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,"5年"]
[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,"4年"]
[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,"3年"]
[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,"2年"]
[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,"1年"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(生活習慣病予防健診申込書①!O1=\"\",\"\",生活習慣病予防健診申込書①!O1)","v":""},null,null,null,null,null,null,null,"今日の日付","2026-02-25",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IF(AND(AN8=\"受診OK\",C9=\"女\"),AO4:AO5,)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1月","1日","元年","元年","元年"]
["2026年度　全国健康保険協会管掌",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No.2",null,null,null,"NO.２",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"付加検診",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2月","2日","2年","2年","2年"]
["生活習慣病予防健診申込書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和泉市立総合医療センター健診センター",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"選択肢",null,null,null,"胃の検査　なし",{"$f":"S10","v":0},{"$f":"S16","v":0},{"$f":"S22","v":0},{"$f":"S28","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3月","3日","3年","3年","3年"]
[null,null,null,null,null,null,null,null,null,"●喀痰細胞診検査（任意）50歳以上で喫煙指数が600以上の方が対象となります。\n・喀痰をお申込みされる方は※1をご確認下さい。\n・2026年度より、35～39歳の方は胃・大腸検査が省略可能の為、お申し出下さい。\n省略される方は下記チェック欄に〇を付けて下さい。（※2）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4月","4日","4年","4年","4年"]
["受診者リスト ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX：0725-51-7287",null,null,null,null,null,null,null,null,"生年月日",null,"希望日",null,null,null,null,null,null,null,null,null,null,null,"有・無","有・無",null,null,null,{"$f":"S11","v":0},{"$f":"S17","v":0},{"$f":"S23","v":0},{"$f":"S29","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5月","5日","5年","5年","5年"]
["申込が確認出来次第、こちらからお電話いたしますのでしばらくお待ちください。",null,null,null,null,null,null,null,null,"●胃カメラ検査：4,400円（税込）追加　鎮静剤：1,100円（税込）追加\n・一般健診項目は、どの項目もすべて受診していただくようになっています。\n・節目健診の肺機能検査は、協会けんぽの通達により未実施とすることがあります。\n・肝炎ウィルス検査は、過去にC型肝炎検査を受けたことがある方は受診出来ません。\n※乳がん検診は妊娠中、授乳中（断乳後6か月以内）、豊胸手術（脂肪注入含む）後、\nペースメーカーやCVポート等を装着中、VPシャントを施工中の方は受診出来ません。",null,null,null,null,null,null,null,null,null,null,null,"病院使用欄",null,null,"病院使用欄",null,null,null,null,null,"昭和","平成","月","日付",null,null,null,null,null,null,null,null,"年齢","一般検診","有","有","○",null,null,{"$f":"S12","v":"鎮静剤"},{"$f":"S18","v":"鎮静剤"},{"$f":"S24","v":"鎮静剤"},{"$f":"S30","v":"鎮静剤"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"6月","6日","6年","6年","6年"]
["フリガナは資格確認書に印字の文字と完全一致で入力をお願いします。\n※患者IDは当院の診察券番号または、過去の健診結果に記載されているカルテ番号をご入力ください。\n任意継続の方は、下記任意継続の欄に○を付けて下さい。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=40,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"64年","1年","4月","1日","元年","①","年齢",{"$f":"E10&F10&E12&F12","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E10)=\"令和\",2018,IF(TRIM(E10)=\"平成\",1988,IF(TRIM(E10)=\"昭和\",1925,0)))+IF(TRIM(F10)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F10),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E12),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F12),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN7,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BK24:BK64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},"無","無",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,"7月","7日","7年","7年","7年"]
["資格確認書\n番号","患者ID\n（診察券番号）","姓（フリガナ）\n名（フリガナ）","性別","生年月日",null,"自宅住所",null,"受診コース（協会けんぽ補助対象）\n○を入力してください",null,null,null,null,null,null,null,null,"バリウム","胃カメラ","35～39歳\n（※2）",null,"希望日","月","日","病院使用欄",null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=20,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"63年","2年","5月","2日","2年",null,"子宮頸がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AL9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AP9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BD24:BD30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"8月","8日","8年","8年","8年"]
[null,null,"氏　名",null,"元号","年","〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),OR(AQ7=40,AQ7=45,AQ7=50,AQ7=55,AQ7=60,AQ7=65,AQ7=70)),\"OK\",\"NG\"),\"NG\")","v":"NG"},"62年","3年","6月","3日","3年",null,null,{"$f":"IF(COUNTIF(AN32:AN51,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,null,{"$f":"IF(COUNTIF(AV24:AV53,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,"子宮頸がん（単独）",{"$f":"IF(COUNTIF(AN24:AN33,\"〇\"),\"受診OK\",\"受診NG\")","v":"受診NG"},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AT9=\"受診OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"9月","9日","9年","9年","9年"]
[null,null,null,null,null,null,null,null,"一般","若年\n一般","子宮頸がん\n（単独）","節目","乳がん","子宮頸がん","骨粗鬆症","肝炎ウィルス","喀痰細胞診\n（※1）",null,null,"胃なし","大腸なし","①",null,null,"ＩＤ",null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=40,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"61年","4年","7月","4日","4年","②","年齢",{"$f":"E16&F16&E18&F18","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E16)=\"令和\",2018,IF(TRIM(E16)=\"平成\",1988,IF(TRIM(E16)=\"昭和\",1925,0)))+IF(TRIM(F16)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F16),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E18),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F18),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN10,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BL24:BL64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},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,"10月","10日","10年","10年","10年"]
[null,null,null,null,"月","日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=20,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"60年","5年","8月","5日","5年",null,"子宮頸がん",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(AND(AL12=\"年齢OK\",D16=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(AND(AP12=\"年齢OK\",D16=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BE24:BE30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"11月","11日","11年","11年","11年"]
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[null,null,null,null,"TEL：",null,null,null,null,null,null,null,null,null,null,null,null,null,"有・無",null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN13>DATE(1951,4,1),AN13<=DATE(2007,4,1),AND(OR(D22=\"女\",D22=\"女性\"),AQ13>=40,ISEVEN(AQ13))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"58年","7年","10月","7日","7年","③","年齢",{"$f":"E22&F22&E24&F24","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E22)=\"令和\",2018,IF(TRIM(E22)=\"平成\",1988,IF(TRIM(E22)=\"昭和\",1925,0)))+IF(TRIM(F22)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F22),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E24),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F24),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN13,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN13<=DATE(1951,4,1),AN13>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BM24:BM64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},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,"13日","13年","13年","13年"]
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[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,"37年","28年",null,"28日",null,null,"40歳","1986-04-02","1987-04-01","×","×","×","×",null,"60歳","1965-04-02","1966-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"45歳","1981-04-02","1982-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"34年"]
[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,"36年","29年",null,"29日",null,null,"42歳","1984-04-02","1985-04-01","×","×","×","×",null,"62歳","1963-04-02","1964-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"46歳","1980-04-02","1981-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"35年"]
[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,"35年","30年",null,"30日",null,null,"44歳","1982-04-02","1983-04-01","×","×","×","×",null,"64歳","1961-04-02","1962-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"47歳","1979-04-02","1980-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"36年"]
[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,"34年","31年",null,"31日",null,null,"46歳","1980-04-02","1981-04-01","×","×","×","×",null,"66歳","1959-04-02","1960-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"37年"]
[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,"33年",null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×","×",null,"68歳","1957-04-02","1958-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"49歳","1977-04-02","1978-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"38年"]
[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,"32年",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×","×",null,"70歳","1955-04-02","1956-04-01","×","×","×","×",null,null,"子宮頸がん（単独）",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"39年"]
[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,"31年",null,null,null,null,null,"52歳","1974-04-02","1975-04-01","×","×","×","×",null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,36,"1989-04-02","1990-04-01",{"$f":"IF(AND($AN$7>=BB40,$AN$7<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB40,$AN$10<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB40,$AN$13<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB40,$AN$16<=BC40),\"〇\",\"×\")","v":"×"},"51歳","1975-04-02","1976-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"40年"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30年",null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×","×",null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,38,"1987-04-02","1988-04-01",{"$f":"IF(AND($AN$7>=BB41,$AN$7<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB41,$AN$10<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB41,$AN$13<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB41,$AN$16<=BC41),\"〇\",\"×\")","v":"×"},"52歳","1974-04-02","1975-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"41年"]
[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,"29年",null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×","×",null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"53歳","1973-04-02","1974-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"42年"]
[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,"28年",null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×","×",null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"43年"]
[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,"27年",null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×","×",null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"55歳","1971-04-02","1972-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"44年"]
[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,"26年",null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×","×",null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"45年"]
[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,"25年",null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×","×",null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"57歳","1969-04-02","1970-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"46年"]
[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,"24年",null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×","×",null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"47年"]
[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,"23年",null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×","×",null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"59歳","1967-04-02","1968-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"48年"]
[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,"22年",null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×","×",null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"49年"]
[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,"21年",null,null,null,null,null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"61歳","1965-04-02","1966-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"50年"]
[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,"20年",null,null,null,null,null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"51年"]
[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,"19年",null,null,null,null,null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"63歳","1963-04-02","1964-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"52年"]
[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,"18年",null,null,null,null,null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"53年"]
[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,"17年",null,null,null,null,null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"65歳","1961-04-02","1962-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"54年"]
[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,"16年",null,null,null,null,null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"55年"]
[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,"15年",null,null,null,null,null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"67歳","1959-04-02","1960-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"56年"]
[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,"14年",null,null,null,null,null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"57年"]
[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,"13年",null,null,null,null,null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"69歳","1957-04-02","1958-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"58年"]
[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,"12年",null,null,null,null,null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"59年"]
[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,"11年",null,null,null,null,null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"71歳","1955-04-02","1956-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"60年"]
[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,"10年",null,null,null,null,null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"72歳","1954-04-02","1955-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"61年"]
[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,"9年",null,null,null,null,null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"73歳","1953-04-02","1954-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"62年"]
[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,"8年",null,null,null,null,null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"74歳","1952-04-02","1953-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"63年"]
[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,"7年",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,"75歳","1951-04-02","1952-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"64年"]
[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,"6年"]
[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,"5年"]
[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,"4年"]
[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,"3年"]
[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,"2年"]
[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,"1年"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(生活習慣病予防健診申込書①!O1=\"\",\"\",生活習慣病予防健診申込書①!O1)","v":""},null,null,null,null,null,null,null,"今日の日付","2026-02-25",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IF(AND(AN8=\"受診OK\",C9=\"女\"),AO4:AO5,)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1月","1日","元年","元年","元年"]
["2026年度　全国健康保険協会管掌",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No.2",null,null,null,"NO.２",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"付加検診",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2月","2日","2年","2年","2年"]
["生活習慣病予防健診申込書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和泉市立総合医療センター健診センター",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"選択肢",null,null,null,"胃の検査　なし",{"$f":"S10","v":0},{"$f":"S16","v":0},{"$f":"S22","v":0},{"$f":"S28","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3月","3日","3年","3年","3年"]
[null,null,null,null,null,null,null,null,null,"●喀痰細胞診検査（任意）50歳以上で喫煙指数が600以上の方が対象となります。\n・喀痰をお申込みされる方は※1をご確認下さい。\n・2026年度より、35～39歳の方は胃・大腸検査が省略可能の為、お申し出下さい。\n省略される方は下記チェック欄に〇を付けて下さい。（※2）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4月","4日","4年","4年","4年"]
["受診者リスト ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX：0725-51-7287",null,null,null,null,null,null,null,null,"生年月日",null,"希望日",null,null,null,null,null,null,null,null,null,null,null,"有・無","有・無",null,null,null,{"$f":"S11","v":0},{"$f":"S17","v":0},{"$f":"S23","v":0},{"$f":"S29","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5月","5日","5年","5年","5年"]
["申込が確認出来次第、こちらからお電話いたしますのでしばらくお待ちください。",null,null,null,null,null,null,null,null,"●胃カメラ検査：4,400円（税込）追加　鎮静剤：1,100円（税込）追加\n・一般健診項目は、どの項目もすべて受診していただくようになっています。\n・節目健診の肺機能検査は、協会けんぽの通達により未実施とすることがあります。\n・肝炎ウィルス検査は、過去にC型肝炎検査を受けたことがある方は受診出来ません。\n※乳がん検診は妊娠中、授乳中（断乳後6か月以内）、豊胸手術（脂肪注入含む）後、\nペースメーカーやCVポート等を装着中、VPシャントを施工中の方は受診出来ません。",null,null,null,null,null,null,null,null,null,null,null,"病院使用欄",null,null,"病院使用欄",null,null,null,null,null,"昭和","平成","月","日付",null,null,null,null,null,null,null,null,"年齢","一般検診","有","有","○",null,null,{"$f":"S12","v":"鎮静剤"},{"$f":"S18","v":"鎮静剤"},{"$f":"S24","v":"鎮静剤"},{"$f":"S30","v":"鎮静剤"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"6月","6日","6年","6年","6年"]
["フリガナは資格確認書に印字の文字と完全一致で入力をお願いします。\n※患者IDは当院の診察券番号または、過去の健診結果に記載されているカルテ番号をご入力ください。\n任意継続の方は、下記任意継続の欄に○を付けて下さい。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=40,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"64年","1年","4月","1日","元年","①","年齢",{"$f":"E10&F10&E12&F12","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E10)=\"令和\",2018,IF(TRIM(E10)=\"平成\",1988,IF(TRIM(E10)=\"昭和\",1925,0)))+IF(TRIM(F10)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F10),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E12),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F12),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN7,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BK24:BK64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},"無","無",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,"7月","7日","7年","7年","7年"]
["資格確認書\n番号","患者ID\n（診察券番号）","姓（フリガナ）\n名（フリガナ）","性別","生年月日",null,"自宅住所",null,"受診コース（協会けんぽ補助対象）\n○を入力してください",null,null,null,null,null,null,null,null,"バリウム","胃カメラ","35～39歳\n（※2）",null,"希望日","月","日","病院使用欄",null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=20,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"63年","2年","5月","2日","2年",null,"子宮頸がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AL9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AP9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BD24:BD30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"8月","8日","8年","8年","8年"]
[null,null,"氏　名",null,"元号","年","〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),OR(AQ7=40,AQ7=45,AQ7=50,AQ7=55,AQ7=60,AQ7=65,AQ7=70)),\"OK\",\"NG\"),\"NG\")","v":"NG"},"62年","3年","6月","3日","3年",null,null,{"$f":"IF(COUNTIF(AN32:AN51,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,null,{"$f":"IF(COUNTIF(AV24:AV53,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,"子宮頸がん（単独）",{"$f":"IF(COUNTIF(AN24:AN33,\"〇\"),\"受診OK\",\"受診NG\")","v":"受診NG"},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AT9=\"受診OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"9月","9日","9年","9年","9年"]
[null,null,null,null,null,null,null,null,"一般","若年\n一般","子宮頸がん\n（単独）","節目","乳がん","子宮頸がん","骨粗鬆症","肝炎ウィルス","喀痰細胞診\n（※1）",null,null,"胃なし","大腸なし","①",null,null,"ＩＤ",null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=40,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"61年","4年","7月","4日","4年","②","年齢",{"$f":"E16&F16&E18&F18","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E16)=\"令和\",2018,IF(TRIM(E16)=\"平成\",1988,IF(TRIM(E16)=\"昭和\",1925,0)))+IF(TRIM(F16)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F16),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E18),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F18),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN10,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BL24:BL64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},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,"10月","10日","10年","10年","10年"]
[null,null,null,null,"月","日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=20,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"60年","5年","8月","5日","5年",null,"子宮頸がん",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(AND(AL12=\"年齢OK\",D16=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(AND(AP12=\"年齢OK\",D16=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BE24:BE30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"11月","11日","11年","11年","11年"]
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[null,null,null,null,"TEL：",null,null,null,null,null,null,null,null,null,null,null,null,null,"有・無",null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN13>DATE(1951,4,1),AN13<=DATE(2007,4,1),AND(OR(D22=\"女\",D22=\"女性\"),AQ13>=40,ISEVEN(AQ13))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"58年","7年","10月","7日","7年","③","年齢",{"$f":"E22&F22&E24&F24","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E22)=\"令和\",2018,IF(TRIM(E22)=\"平成\",1988,IF(TRIM(E22)=\"昭和\",1925,0)))+IF(TRIM(F22)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F22),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E24),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F24),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN13,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN13<=DATE(1951,4,1),AN13>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BM24:BM64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},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,"13日","13年","13年","13年"]
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[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,"37年","28年",null,"28日",null,null,"40歳","1986-04-02","1987-04-01","×","×","×","×",null,"60歳","1965-04-02","1966-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"45歳","1981-04-02","1982-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"34年"]
[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,"36年","29年",null,"29日",null,null,"42歳","1984-04-02","1985-04-01","×","×","×","×",null,"62歳","1963-04-02","1964-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"46歳","1980-04-02","1981-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"35年"]
[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,"35年","30年",null,"30日",null,null,"44歳","1982-04-02","1983-04-01","×","×","×","×",null,"64歳","1961-04-02","1962-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"47歳","1979-04-02","1980-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"36年"]
[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,"34年","31年",null,"31日",null,null,"46歳","1980-04-02","1981-04-01","×","×","×","×",null,"66歳","1959-04-02","1960-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"37年"]
[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,"33年",null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×","×",null,"68歳","1957-04-02","1958-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"49歳","1977-04-02","1978-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"38年"]
[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,"32年",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×","×",null,"70歳","1955-04-02","1956-04-01","×","×","×","×",null,null,"子宮頸がん（単独）",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"39年"]
[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,"31年",null,null,null,null,null,"52歳","1974-04-02","1975-04-01","×","×","×","×",null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,36,"1989-04-02","1990-04-01",{"$f":"IF(AND($AN$7>=BB40,$AN$7<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB40,$AN$10<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB40,$AN$13<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB40,$AN$16<=BC40),\"〇\",\"×\")","v":"×"},"51歳","1975-04-02","1976-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"40年"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30年",null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×","×",null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,38,"1987-04-02","1988-04-01",{"$f":"IF(AND($AN$7>=BB41,$AN$7<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB41,$AN$10<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB41,$AN$13<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB41,$AN$16<=BC41),\"〇\",\"×\")","v":"×"},"52歳","1974-04-02","1975-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"41年"]
[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,"29年",null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×","×",null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"53歳","1973-04-02","1974-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"42年"]
[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,"28年",null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×","×",null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"43年"]
[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,"27年",null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×","×",null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"55歳","1971-04-02","1972-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"44年"]
[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,"26年",null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×","×",null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"45年"]
[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,"25年",null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×","×",null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"57歳","1969-04-02","1970-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"46年"]
[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,"24年",null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×","×",null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"47年"]
[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,"23年",null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×","×",null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"59歳","1967-04-02","1968-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"48年"]
[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,"22年",null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×","×",null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"49年"]
[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,"21年",null,null,null,null,null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"61歳","1965-04-02","1966-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"50年"]
[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,"20年",null,null,null,null,null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"51年"]
[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,"19年",null,null,null,null,null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"63歳","1963-04-02","1964-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"52年"]
[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,"18年",null,null,null,null,null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"53年"]
[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,"17年",null,null,null,null,null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"65歳","1961-04-02","1962-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"54年"]
[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,"16年",null,null,null,null,null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"55年"]
[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,"15年",null,null,null,null,null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"67歳","1959-04-02","1960-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"56年"]
[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,"14年",null,null,null,null,null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"57年"]
[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,"13年",null,null,null,null,null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"69歳","1957-04-02","1958-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"58年"]
[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,"12年",null,null,null,null,null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"59年"]
[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,"11年",null,null,null,null,null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"71歳","1955-04-02","1956-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"60年"]
[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,"10年",null,null,null,null,null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"72歳","1954-04-02","1955-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"61年"]
[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,"9年",null,null,null,null,null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"73歳","1953-04-02","1954-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"62年"]
[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,"8年",null,null,null,null,null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"74歳","1952-04-02","1953-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"63年"]
[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,"7年",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,"75歳","1951-04-02","1952-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"64年"]
[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,"6年"]
[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,"5年"]
[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,"4年"]
[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,"3年"]
[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,"2年"]
[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,"1年"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(生活習慣病予防健診申込書①!O1=\"\",\"\",生活習慣病予防健診申込書①!O1)","v":""},null,null,null,null,null,null,null,"今日の日付","2026-02-25",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IF(AND(AN8=\"受診OK\",C9=\"女\"),AO4:AO5,)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1月","1日","元年","元年","元年"]
["2026年度　全国健康保険協会管掌",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No.2",null,null,null,"NO.２",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"付加検診",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2月","2日","2年","2年","2年"]
["生活習慣病予防健診申込書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和泉市立総合医療センター健診センター",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"選択肢",null,null,null,"胃の検査　なし",{"$f":"S10","v":0},{"$f":"S16","v":0},{"$f":"S22","v":0},{"$f":"S28","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3月","3日","3年","3年","3年"]
[null,null,null,null,null,null,null,null,null,"●喀痰細胞診検査（任意）50歳以上で喫煙指数が600以上の方が対象となります。\n・喀痰をお申込みされる方は※1をご確認下さい。\n・2026年度より、35～39歳の方は胃・大腸検査が省略可能の為、お申し出下さい。\n省略される方は下記チェック欄に〇を付けて下さい。（※2）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4月","4日","4年","4年","4年"]
["受診者リスト ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX：0725-51-7287",null,null,null,null,null,null,null,null,"生年月日",null,"希望日",null,null,null,null,null,null,null,null,null,null,null,"有・無","有・無",null,null,null,{"$f":"S11","v":0},{"$f":"S17","v":0},{"$f":"S23","v":0},{"$f":"S29","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5月","5日","5年","5年","5年"]
["申込が確認出来次第、こちらからお電話いたしますのでしばらくお待ちください。",null,null,null,null,null,null,null,null,"●胃カメラ検査：4,400円（税込）追加　鎮静剤：1,100円（税込）追加\n・一般健診項目は、どの項目もすべて受診していただくようになっています。\n・節目健診の肺機能検査は、協会けんぽの通達により未実施とすることがあります。\n・肝炎ウィルス検査は、過去にC型肝炎検査を受けたことがある方は受診出来ません。\n※乳がん検診は妊娠中、授乳中（断乳後6か月以内）、豊胸手術（脂肪注入含む）後、\nペースメーカーやCVポート等を装着中、VPシャントを施工中の方は受診出来ません。",null,null,null,null,null,null,null,null,null,null,null,"病院使用欄",null,null,"病院使用欄",null,null,null,null,null,"昭和","平成","月","日付",null,null,null,null,null,null,null,null,"年齢","一般検診","有","有","○",null,null,{"$f":"S12","v":"鎮静剤"},{"$f":"S18","v":"鎮静剤"},{"$f":"S24","v":"鎮静剤"},{"$f":"S30","v":"鎮静剤"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"6月","6日","6年","6年","6年"]
["フリガナは資格確認書に印字の文字と完全一致で入力をお願いします。\n※患者IDは当院の診察券番号または、過去の健診結果に記載されているカルテ番号をご入力ください。\n任意継続の方は、下記任意継続の欄に○を付けて下さい。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=40,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"64年","1年","4月","1日","元年","①","年齢",{"$f":"E10&F10&E12&F12","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E10)=\"令和\",2018,IF(TRIM(E10)=\"平成\",1988,IF(TRIM(E10)=\"昭和\",1925,0)))+IF(TRIM(F10)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F10),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E12),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F12),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN7,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BK24:BK64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},"無","無",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,"7月","7日","7年","7年","7年"]
["資格確認書\n番号","患者ID\n（診察券番号）","姓（フリガナ）\n名（フリガナ）","性別","生年月日",null,"自宅住所",null,"受診コース（協会けんぽ補助対象）\n○を入力してください",null,null,null,null,null,null,null,null,"バリウム","胃カメラ","35～39歳\n（※2）",null,"希望日","月","日","病院使用欄",null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),AND(OR(D10=\"女\",D10=\"女性\"),AQ7>=20,ISEVEN(AQ7))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"63年","2年","5月","2日","2年",null,"子宮頸がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AL9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AP9=\"年齢OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BD24:BD30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"8月","8日","8年","8年","8年"]
[null,null,"氏　名",null,"元号","年","〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN7>DATE(1951,4,1),AN7<=DATE(2007,4,1),OR(AQ7=40,AQ7=45,AQ7=50,AQ7=55,AQ7=60,AQ7=65,AQ7=70)),\"OK\",\"NG\"),\"NG\")","v":"NG"},"62年","3年","6月","3日","3年",null,null,{"$f":"IF(COUNTIF(AN32:AN51,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,null,{"$f":"IF(COUNTIF(AV24:AV53,\"〇\"),\"年齢OK\",\"受診NG\")","v":"受診NG"},null,null,"子宮頸がん（単独）",{"$f":"IF(COUNTIF(AN24:AN33,\"〇\"),\"受診OK\",\"受診NG\")","v":"受診NG"},{"$f":"IF(OR(AN7<=DATE(1951,4,1),AN7>DATE(2007,4,1)),\"受診NG\",IF(AND(AT9=\"受診OK\",D10=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"9月","9日","9年","9年","9年"]
[null,null,null,null,null,null,null,null,"一般","若年\n一般","子宮頸がん\n（単独）","節目","乳がん","子宮頸がん","骨粗鬆症","肝炎ウィルス","喀痰細胞診\n（※1）",null,null,"胃なし","大腸なし","①",null,null,"ＩＤ",null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=40,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"61年","4年","7月","4日","4年","②","年齢",{"$f":"E16&F16&E18&F18","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E16)=\"令和\",2018,IF(TRIM(E16)=\"平成\",1988,IF(TRIM(E16)=\"昭和\",1925,0)))+IF(TRIM(F16)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F16),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E18),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F18),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN10,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BL24:BL64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},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,"10月","10日","10年","10年","10年"]
[null,null,null,null,"月","日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN10>DATE(1951,4,1),AN10<=DATE(2007,4,1),AND(OR(D16=\"女\",D16=\"女性\"),AQ10>=20,ISEVEN(AQ10))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"60年","5年","8月","5日","5年",null,"子宮頸がん",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(AND(AL12=\"年齢OK\",D16=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"乳がん",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(AND(AP12=\"年齢OK\",D16=\"女\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},null,null,"付加検診",{"$f":"IF(OR(AN10<=DATE(1951,4,1),AN10>DATE(2007,4,1)),\"受診NG\",IF(COUNTIF(BE24:BE30,\"〇\"),\"受診OK\",\"受診NG\"))","v":"受診NG"},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,"11月","11日","11年","11年","11年"]
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[null,null,null,null,"TEL：",null,null,null,null,null,null,null,null,null,null,null,null,null,"有・無",null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(AND(AN13>DATE(1951,4,1),AN13<=DATE(2007,4,1),AND(OR(D22=\"女\",D22=\"女性\"),AQ13>=40,ISEVEN(AQ13))),\"OK\",\"NG\"),\"NG\")","v":"NG"},"58年","7年","10月","7日","7年","③","年齢",{"$f":"E22&F22&E24&F24","v":""},"変換→",{"$f":"IFERROR(DATE(IF(TRIM(E22)=\"令和\",2018,IF(TRIM(E22)=\"平成\",1988,IF(TRIM(E22)=\"昭和\",1925,0)))+IF(TRIM(F22)=\"元年\",1,--ASC(SUBSTITUTE(TRIM(F22),\"年\",\"\"))),--ASC(SUBSTITUTE(TRIM(E24),\"月\",\"\")),--ASC(SUBSTITUTE(TRIM(F24),\"日\",\"\"))),\"\")","v":""},"○",null,{"$f":"IFERROR(DATEDIF(AN13,DATE(YEAR($AE$1)+(MONTH($AE$1)>=4)+1,4,1),\"Y\"),\"\")","v":""},{"$f":"IF(OR(AN13<=DATE(1951,4,1),AN13>DATE(2007,4,1)),\"NG\",IF(COUNTIF(BM24:BM64,\"〇\"),\"OK\",\"NG\"))","v":"NG"},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,"13日","13年","13年","13年"]
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[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,"37年","28年",null,"28日",null,null,"40歳","1986-04-02","1987-04-01","×","×","×","×",null,"60歳","1965-04-02","1966-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"45歳","1981-04-02","1982-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"34年"]
[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,"36年","29年",null,"29日",null,null,"42歳","1984-04-02","1985-04-01","×","×","×","×",null,"62歳","1963-04-02","1964-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"46歳","1980-04-02","1981-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"35年"]
[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,"35年","30年",null,"30日",null,null,"44歳","1982-04-02","1983-04-01","×","×","×","×",null,"64歳","1961-04-02","1962-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"47歳","1979-04-02","1980-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"36年"]
[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,"34年","31年",null,"31日",null,null,"46歳","1980-04-02","1981-04-01","×","×","×","×",null,"66歳","1959-04-02","1960-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"37年"]
[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,"33年",null,null,null,null,null,"48歳","1978-04-02","1979-04-01","×","×","×","×",null,"68歳","1957-04-02","1958-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"49歳","1977-04-02","1978-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"38年"]
[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,"32年",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×","×",null,"70歳","1955-04-02","1956-04-01","×","×","×","×",null,null,"子宮頸がん（単独）",null,null,null,null,null,"50歳","1976-04-02","1977-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"39年"]
[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,"31年",null,null,null,null,null,"52歳","1974-04-02","1975-04-01","×","×","×","×",null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,36,"1989-04-02","1990-04-01",{"$f":"IF(AND($AN$7>=BB40,$AN$7<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB40,$AN$10<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB40,$AN$13<=BC40),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB40,$AN$16<=BC40),\"〇\",\"×\")","v":"×"},"51歳","1975-04-02","1976-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"40年"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30年",null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×","×",null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,38,"1987-04-02","1988-04-01",{"$f":"IF(AND($AN$7>=BB41,$AN$7<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$10>=BB41,$AN$10<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$13>=BB41,$AN$13<=BC41),\"〇\",\"×\")","v":"×"},{"$f":"IF(AND($AN$16>=BB41,$AN$16<=BC41),\"〇\",\"×\")","v":"×"},"52歳","1974-04-02","1975-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"41年"]
[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,"29年",null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×","×",null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"53歳","1973-04-02","1974-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"42年"]
[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,"28年",null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×","×",null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"54歳","1972-04-02","1973-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"43年"]
[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,"27年",null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×","×",null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"55歳","1971-04-02","1972-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"44年"]
[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,"26年",null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×","×",null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"56歳","1970-04-02","1971-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"45年"]
[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,"25年",null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×","×",null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"57歳","1969-04-02","1970-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"46年"]
[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,"24年",null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×","×",null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"58歳","1968-04-02","1969-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"47年"]
[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,"23年",null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×","×",null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"59歳","1967-04-02","1968-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"48年"]
[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,"22年",null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×","×",null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"60歳","1966-04-02","1967-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"49年"]
[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,"21年",null,null,null,null,null,"72歳","1953-04-02","1954-04-01","×","×","×","×",null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"61歳","1965-04-02","1966-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"50年"]
[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,"20年",null,null,null,null,null,"74歳","1951-04-02","1952-04-01","×","×","×","×",null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"62歳","1964-04-02","1965-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"51年"]
[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,"19年",null,null,null,null,null,"76歳","1949-04-02","1950-04-01","×","×","×","×",null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"63歳","1963-04-02","1964-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"52年"]
[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,"18年",null,null,null,null,null,"78歳","1947-04-02","1948-04-01","×","×","×","×",null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,"64歳","1962-04-02","1963-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"53年"]
[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,"17年",null,null,null,null,null,"80歳","1945-04-02","1946-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"65歳","1961-04-02","1962-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"54年"]
[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,"16年",null,null,null,null,null,"82歳","1943-04-02","1944-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"66歳","1960-04-02","1961-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"55年"]
[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,"15年",null,null,null,null,null,"84歳","1941-04-02","1942-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"67歳","1959-04-02","1960-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"56年"]
[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,"14年",null,null,null,null,null,"86歳","1939-04-02","1940-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"68歳","1958-04-02","1959-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"57年"]
[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,"13年",null,null,null,null,null,"88歳","1937-04-02","1938-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"69歳","1957-04-02","1958-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"58年"]
[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,"12年",null,null,null,null,null,"90歳","1935-04-02","1936-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"70歳","1956-04-02","1957-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"59年"]
[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,"11年",null,null,null,null,null,"92歳","1933-04-02","1934-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"71歳","1955-04-02","1956-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"60年"]
[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,"10年",null,null,null,null,null,"94歳","1931-04-02","1932-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"72歳","1954-04-02","1955-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"61年"]
[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,"9年",null,null,null,null,null,"96歳","1929-04-02","1930-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"73歳","1953-04-02","1954-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"62年"]
[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,"8年",null,null,null,null,null,"98歳","1927-04-02","1928-04-01","×","×","×","×",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"74歳","1952-04-02","1953-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"63年"]
[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,"7年",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,"75歳","1951-04-02","1952-04-01","×","×","×",null,"×",null,null,null,null,null,null,null,null,"64年"]
[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,"6年"]
[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,"5年"]
[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,"4年"]
[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,"3年"]
[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,"2年"]
[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,"1年"]