{"text_format":"1","workbook":"xlsx","n_sheets":1,"sheets":["book1"],"not_rendered":{"charts":0,"images":44,"macros":1,"external_links":0,"defined_names":0,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"book1","index":0,"n_rows":38,"n_cols":13,"rows_kept":38,"cut":false,"hidden":false,"merged":[[5,2,6,4],[0,12,0,13],[11,1,11,12],[5,9,5,11],[37,4,37,6],[37,8,37,11],[15,1,15,12],[19,1,20,2],[19,7,20,8],[25,4,25,9],[29,8,33,12],[18,3,18,4],[17,3,17,4],[19,3,19,4],[20,3,20,4],[23,1,23,12],[19,11,19,12],[20,11,20,12]]}
["　初診患者様用FAX事前予約用紙　診療情報提供書 ",null,null,null,null,null,null,null,null,null,null,null,{"$f":"TODAY()","v":"2019-04-02"}]
[]
[" ご紹介先",null,null,null,null,null,"ご紹介元"]
[]
[null,"【公立八鹿病院】",null,null,null,null,null,null,"【   　　　　　　  】"]
[null,null,"　　　　    　　　　　先生",null,null,null,null,null,null,"  　　　 　先生"]
[]
[null,null,"* 医師名が不明の場合は診療科のみご選択ください",null,null,null,null,null,null,"TEL\n FAX "]
[]
[]
[" ご紹介先（□欄にレ印をつけてください）"]
[null,"                       （救急の場合は直接総合診療科へ電話連絡をください） ご来院方法（                                                             ）"]
[]
[]
[]
[]
[" 患者様情報　　（八鹿病院のカルテ番号がお分かりになればご記入ください　<No.　　　　　　   　　　　　　> ）"]
[null,"フリガナ",null,null,null,null,null,"生年月日"]
[null,"氏名",null,null,null,null,null,null,null,"　　　　　　年　　月　　日（　　歳）"]
[null,"住所",null,"〒",null,null,null,"連絡先",null,"TEL"]
[null,null,null,null,null,null,null,null,null,"携帯"]
[]
[" 紹介目的及び依頼内容（診療情報提供書が同時にFAX出来ない場合は、この欄にご記入ください）"]
[]
[null,"　*薬剤アレルギー（　　　　　　　）    　*妊娠の可能性（　　　　　　　　　）"]
[]
["   　 備考　",null,null,null,null,null,null,null,null,"（　　　　医師）"]
[]
[" 受診希望日"]
[null,"第１希望　　　月　　　日　　曜日（ご希望に添えない",null,null,null,null,null,null,"患者様のご都合のつかない日がありましたら、                                       　あらかじめお教えください"]
[null,"第２希望　　　月　　　日　　曜日　場合があります）"]
[null,"　　　　　     　  　（緊急性の有無　　　　　　　　）"]
[null,"　　　　　　　（なるべく早い予約枠をおとりします）"]
[null,"　    　　（患者様予約 *予約方法の説明書もお渡しください）"]
[]
[]
[null," 〒667-8555   兵庫県養父市八鹿町八鹿1878番地1",null,null,null,null,null,null,"公立八鹿病院　地域医療連携室"]
[null,null,null,null,"TEL 079-662-5555（内線1360）",null,null,null," FAX 079-662-3143（直通）"]