{"text_format":"2","workbook":"xls","n_sheets":2,"sheets":["申請書","申請書　現物"],"not_rendered":{"charts":0,"images":0,"macros":0,"external_links":0,"defined_names":0,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"run_cost":"one","rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900","formulas":"cached_only"}

{"sheet":"申請書","index":0,"n_rows":38,"n_cols":14,"rows_kept":38,"cut":false,"hidden":false,"merged":[[34,0,34,8],[34,12,34,13],[35,0,35,5],[31,1,31,13],[33,0,33,8],[33,10,37,10],[33,12,33,13],[29,1,29,2],[29,3,29,5],[29,8,29,9],[29,10,29,13],[30,1,30,2],[30,3,30,5],[30,8,30,9],[30,10,30,13],[27,1,27,2],[27,3,27,5],[27,8,27,9],[27,10,27,13],[28,1,28,2],[28,3,28,5],[28,8,28,9],[28,10,28,13],[25,8,25,9],[25,10,25,13],[26,1,26,2],[26,3,26,5],[26,8,26,9],[26,10,26,13],[19,3,19,7],[19,9,19,13],[21,0,23,0],[24,0,30,0],[24,1,24,2],[24,3,24,5],[24,8,24,9],[24,10,24,13],[25,1,25,2],[25,3,25,5],[16,0,20,0],[16,1,16,3],[16,5,16,8],[16,10,16,13],[17,2,17,3],[17,4,17,9],[17,10,17,13],[18,1,18,2],[18,3,18,13],[19,1,20,1],[12,0,13,1],[12,4,12,11],[14,0,15,1],[14,2,14,13],[15,3,15,6],[15,8,15,9],[0,2,0,12],[3,1,3,3],[9,10,9,11],[11,0,11,1],[11,2,11,5],[11,6,11,7],[11,8,11,10]],"flags":["formulas_cached_only"]}
[null,null,"福祉医療費受給者証（交付・更新）申請書"]
[]
[{"$nulls":5},"障害者"]
[null,"下記のとおり福祉医療費",null,null,null,"母子家庭の母",null,null,"受給者証を　交付　・　更新　してください。"]
[{"$nulls":5},"父子家庭の父"]
[]
[]
[{"$nulls":11},"令和　　　　年　　  月　　　日"]
[]
[{"$nulls":10},"申請者　",null,null,"㊞"]
[]
["該当者氏名",{"$nulls":5},"生年月日",null,"T ・ S ・ H ・ R",null,null," 年","月","日"]
["住　　　　所",null,"    青木村大字"]
[{"$nulls":8},"電話（　　　　　　　）　　　　－"]
["振　込　先",null,"  1.  信州うえだ農業協同組合　青木支所 　　２.　その他　　　　　　　　　　　　　　　　　　　　　　"]
[null,null,"口座名義人",{"$nulls":5},"口座番号"]
["加入医療保険","被　保　険　者　名",null,null,null,"保　険　種　別",{"$nulls":4},"記　号　・　番　号"]
[{"$nulls":4},"全協　・　組合　・　共済　・　国保　・後期"]
[null,"被保険者証発行機関名"]
[null,"勤務先","名　称",{"$nulls":5},"電　話","　（　　　　　　　）　　　　－"]
[null,null,"住　所"]
["該当区分","障害者","　身障手帳 ・ 療育手帳 ・ 65歳以上国民年金別表該当 ・ 保健福祉手帳 ・ 障害年金受給"]
[null,"母子家庭","　母子家庭の母 "]
[null,"父子家庭","　父子家庭の父 "]
["世帯の状況","氏　　　名",null,"生　年　月　日",null,null,"年齢","続柄","職　業",null,"前年の所得額"]
[]
[]
[]
[]
[]
[]
["取得事由","□　出生　　□　転入　　□　所得要件該当　　□　手帳取得　　□　新規資格該当　　□　資格変更　□　再発行　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　□　記載事項変更　　□　年金受給　　□　保険証変更　　□　口座変更　　□　転居　　□　その他"]
[]
["上記のとおり福祉医療費受給者証の　交付　・　更新　を申請します。",{"$nulls":9},"確認欄","区  分","該当　・　非該当"]
["また、申請にあたり必要となる、私及び同一世帯の住基台帳、課税状況",{"$nulls":10},"所  得","該当　・　非該当"]
["等資料を青木村が閲覧することを承諾します。",{"$nulls":10},"確 認 印"]
[{"$nulls":11},"資格発生日"]
[{"$nulls":11},"発行日"]

{"sheet":"申請書　現物","index":1,"n_rows":39,"n_cols":14,"rows_kept":39,"cut":false,"hidden":false,"merged":[[34,10,38,10],[32,1,32,13],[31,1,31,2],[31,3,31,5],[31,8,31,9],[31,10,31,13],[34,0,34,8],[34,12,34,13],[35,0,35,8],[35,12,35,13],[36,0,36,5],[29,1,29,2],[29,3,29,5],[29,8,29,9],[29,10,29,13],[30,1,30,2],[30,3,30,5],[30,8,30,9],[30,10,30,13],[27,1,27,2],[27,3,27,5],[27,8,27,9],[27,10,27,13],[28,1,28,2],[28,3,28,5],[28,8,28,9],[28,10,28,13],[21,0,24,0],[25,0,31,0],[25,1,25,2],[25,3,25,5],[25,8,25,9],[25,10,25,13],[26,1,26,2],[26,3,26,5],[26,8,26,9],[26,10,26,13],[17,4,17,9],[17,10,17,13],[18,1,18,2],[18,3,18,13],[19,1,20,1],[19,3,19,7],[19,9,19,13],[0,2,0,12],[3,1,3,3],[9,10,9,11],[11,0,11,1],[11,2,11,5],[16,0,20,0],[16,1,16,3],[16,5,16,8],[16,10,16,13],[17,2,17,3],[11,6,11,7],[11,8,11,10],[12,0,13,1],[12,4,12,11],[14,0,15,1],[15,3,15,6],[15,8,15,9]],"flags":["formulas_cached_only"]}
[null,null,"福祉医療費現物給付受給者証（交付・更新）申請書"]
[]
[{"$nulls":5},"　乳幼児・児童"]
[null,"下記のとおり福祉医療費",null,null,null,"　障害児",null,null,"　　受給者証を　交付　・　更新　してください。"]
[{"$nulls":5},"　母子家庭の子"]
[{"$nulls":5},"　父子家庭の子"]
[]
[{"$nulls":11},"令和　　　年　　　月　　　日"]
[]
[{"$nulls":10},"申請者　",null,null,"㊞"]
[]
["該当者氏名",{"$nulls":5},"生年月日",null,"T ・ S ・ H ・ R",null,null," 年","月","日"]
["住　　　　所",null,"    青木村大字"]
[{"$nulls":8},"電話（　　　　　　　）　　　　－"]
["振　込　先",null,"  1.  信州うえだ農業協同組合　青木支所 　　２.　その他　　　　　　　　　　　　　　　　　　　　　　"]
[null,null,"口座名義人",{"$nulls":5},"口座番号"]
["加入医療保険","被　保　険　者　名",null,null,null,"保　険　種　別",{"$nulls":4},"記　号　・　番　号"]
[{"$nulls":4},"全協　・　組合　・　共済　・　国保　"]
[null,"被保険者証発行機関名"]
[null,"保護者　　　　勤務先","名　称",{"$nulls":5},"電　話","　（　　　　　　　）　　　　－"]
[null,null,"住　所"]
["該当区分","乳幼児・児童","　乳幼児 ・ 児童　・ 中高生"]
[null,"障害児","　身障手帳 ・ 療育手帳 ・ 保健福祉手帳 "]
[null,"母子家庭","　母子家庭の乳幼児・児童・中高生"]
[null,"父子家庭","　父子家庭の乳幼児・児童・中高生"]
["世帯の状況","氏　　　名",null,"生　年　月　日",null,null,"年齢","続柄","職　業",null,"前年の所得額"]
[]
[]
[]
[]
[]
[]
["取得事由","□　出生　　□　転入　　□　所得要件該当　　□　手帳取得　　□　新規資格該当　　□　資格変更　□　再発行　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　□　記載事項変更　　□　年金受給　　□　保険証変更　　□　口座変更　　□　転居　　□　その他"]
[]
["上記のとおり福祉医療費受給者証の　交付　・　更新　を申請します。",{"$nulls":9},"確認欄","区  分","該当　・　非該当"]
["また、申請にあたり必要となる、私及び同一世帯の住基台帳、課税状況",{"$nulls":10},"所  得","該当　・　非該当"]
["等資料を青木村が閲覧することを承諾します。",{"$nulls":10},"確 認 印"]
[{"$nulls":11},"資格発生日"]
[{"$nulls":11},"発行日"]