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{"sheet":"表紙","index":0,"n_rows":16,"n_cols":11,"rows_kept":16,"cut":false,"hidden":false,"merged":[[16,6,17,11],[15,1,15,3],[3,1,3,9],[10,2,10,9],[13,1,13,3],[14,1,14,3],[6,2,6,9],[7,2,7,9],[8,2,8,9],[9,2,9,9],[13,6,14,11],[4,1,4,9],[5,1,5,9]]}
[]
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[null,"令和８年 患者調査 調査票（一般診療所用）",null,null,null,null,null,null,null,null,"【ver1.2】"]
[]
[null,null,null,null,null,null,null,null,null,null," "]
[null,"都道府県",{"$f":"IF(マスタ!AA3=\"\",\"\",マスタ!AA3)","v":""}]
[null,"施設番号",{"$f":"IF(マスタ!AA5=\"\",\"\",マスタ!AA5)","v":""}]
[null,"施設名"]
[null,"調査日",{"$f":"IF(マスタ!AA9=\"\",\"\",\"令和８年１０月\"&マスタ!AA9)","v":""}]
[null,"調査の対象",""]
[]
[]
[null,"①一般診療所票（入院）",null,null,""]
[null,"②一般診療所票（外来）",null,null,""]
[null,"③一般診療所退院票",null,null,""]

{"sheet":"DATA","index":1,"n_rows":1950,"n_cols":12,"rows_kept":1950,"cut":false,"hidden":true,"merged":[]}
["項番","階層\nレベ\nル１","階層\nレベ\nル２","階層\nレベ\nル３","フィールド種類","項目名","タグ名","プレプリント","入力値",null,null,"<?xml version=\"1.0\" encoding=\"UTF-8\"?>"]
[{"$f":"ROW()-1","v":1},1,null,null,"サブフォーム","対象者認証情報格納エリア","taishosha_cer"]
[{"$f":"ROW()-1","v":2},null,1,null,"テキストフィールド","認証統計調査コード","cer_toke_cd"]
[{"$f":"ROW()-1","v":3},null,2,null,"テキストフィールド","認証調査対象者ID","cer_taishosha_id"]
[4,null,3,null,"テキストフィールド","確認コード","cer_kakunin_cd"]
[5,null,4,null,"テキストフィールド","36進統計調査コード","toke_cd_36"]
[6,null,5,null,"テキストフィールド","送信先URL1","soshin1"]
[7,null,6,null,"テキストフィールド","送信先URL2","soshin2"]
[8,2,null,null,"サブフォーム","管理情報格納エリア","kanri"]
[9,null,1,null,"テキストフィールド","統計調査コード","toke_cd",null,"01"]
[10,null,2,null,"テキストフィールド","実施時期コード","jiki_cd",null,"02"]
[11,null,3,null,"テキストフィールド","調査対象者ID","taishosha_id"]
[12,null,4,null,"テキストフィールド","電子調査票ID","chosahyo_id"]
[13,null,5,null,"テキストフィールド","キー項目","key_komoku"]
[14,3,null,null,"サブフォーム","連絡先情報格納エリア","renraku"]
[15,null,1,null,"テキストフィールド","メールアドレス","mail_adr"]
[16,null,2,null,"テキストフィールド","氏名","shime"]
[17,null,3,null,"テキストフィールド","会社名","kaisha"]
[18,null,4,null,"テキストフィールド","英文会社名","kaisha_e",null,0]
[19,null,5,null,"テキストフィールド","商号","shogo",null,0]
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[21,null,7,null,"テキストフィールド","店舗名","tempo"]
[22,null,8,null,"テキストフィールド","代表者名","daihyosha"]
[23,null,9,null,"テキストフィールド","法人名","hojin"]
[24,null,10,null,"テキストフィールド","学校名","gakko"]
[25,null,11,null,"テキストフィールド","部署名","busho",null,0]
[26,null,12,null,"テキストフィールド","担当者名","tantosha"]
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[28,null,14,null,"テキストフィールド","所在地","shozaichi"]
[29,null,15,null,"テキストフィールド","本社・本店所在地","shozaichi_2"]
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[32,null,18,null,"テキストフィールド","本社・本店郵便番号","yubin_no_2"]
[33,null,19,null,"テキストフィールド","電話番号","tel_no"]
[34,null,20,null,"テキストフィールド","本社・本店電話番号","tel_no_2"]
[35,null,21,null,"テキストフィールド","内線番号","naisen_no"]
[36,null,22,null,"テキストフィールド","携帯電話番号","ketai_no"]
[37,null,23,null,"テキストフィールド","ＦＡＸ番号","fax_no"]
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[40,null,26,null,"テキストフィールド","備考３","biko_3"]
[41,4,null,null,"サブフォーム","調査票回答格納エリア","kaito"]
[42,null,1,null,"テキストフィールド","都道府県コード","todofuken_cd"]
[43,null,2,null,"テキストフィールド","施設番号","shisetsu_bango"]
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[1900,null,1859,null,"テキストフィールド","退院251","taiin_251"]
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[{"$f":"ROW()-1","v":1906},null,1865,null,"テキストフィールド","退院257","taiin_257"]
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[1934,null,1893,null,"テキストフィールド","退院285","taiin_285"]
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[1940,null,1899,null,"テキストフィールド","退院291","taiin_291"]
[1941,null,1900,null,"テキストフィールド","退院292","taiin_292"]
[1942,null,1901,null,"テキストフィールド","退院293","taiin_293"]
[1943,null,1902,null,"テキストフィールド","退院294","taiin_294"]
[1944,null,1903,null,"テキストフィールド","退院295","taiin_295"]
[1945,null,1904,null,"テキストフィールド","退院296","taiin_296"]
[1946,null,1905,null,"テキストフィールド","退院297","taiin_297"]
[1947,null,1906,null,"テキストフィールド","退院298","taiin_298"]
[1948,null,1907,null,"テキストフィールド","退院299","taiin_299"]
[1949,null,1908,null,"テキストフィールド","退院300","taiin_300"]

{"sheet":"一般診療所票（入院）_単記","index":2,"n_rows":54,"n_cols":6,"rows_kept":54,"cut":false,"hidden":true,"merged":[[5,0,5,1],[14,0,17,0],[38,1,40,1],[42,1,45,1],[22,1,37,1],[38,0,45,0],[47,0,48,0],[8,0,11,0],[12,0,13,0],[18,0,37,0],[6,0,6,1]]}
[null,null,null,"・「入力のしかた」ボタンをクリックすると、選択している項目の入力のしかたが表示されます。"]
[null,null,null,"・すべての入力が終わりましたら「エラーチェック・保存」ボタンをクリックしてください。"]
[null,null,null,"・セル表示：桃色　 → エラー箇所を表示しています。"]
[]
[]
["項目名",null,"入力欄","凡例（選択項目（数字を入力する項目）は半角英数字で入力してください）"]
["患者番号（自動入力）",null,{"$f":"F7","v":"0001"},null,null,"0001"]
["(1)性別","性別",null,"1:男　2:女"]
["(2)出生年月日","元号",null,"1:令和　2:平成　3:昭和　4:大正　5:明治　※推定年齢を記入する場合は「入力のしかた」を参照"]
[null,"年",null,"1～99"]
[null,"月",null,"1～91"]
[null,"日",null,"0～99"]
["(3)患者の住所","当院と同別",null,"1:当院と同じ都道府県内　2:当院とは別の都道府県"]
[null,"都道府県\n（当院と同別が「２：当院とは別の都道府県」の場合のみ記入）","","全角４文字以内で入力してください"]
["(4)入院年月日","元号",null,"1:令和　2:平成　3:昭和"]
[null,"年",null,"1～64"]
[null,"月",null,"1～12"]
[null,"日",null,"1～31"]
["(5)受療の状況","受療の状況\n（2～6を選択した場合、 「（6）診療費等支払方法」の入力へ進む）\n",null,"1:傷病の診断・治療\n2:正常分娩(単胎自然分娩)\n3:正常妊娠・産じょくの管理\n4:健康者に対する検査、健康診断(査)・管理\n5:予防接種\n6:その他の保健サービス"]
[null,"(1)主傷病名\n（受療の状況が「1.傷病の診断・治療」の場合のみ記入）",null,"全角４０文字以内で入力してください"]
[null,"肝疾患の状況\n（主傷病名が「慢性肝炎」、「肝硬変」又は「肝及び肝内胆管の悪性新生物」の場合のみ記入）",null,"1:B型肝炎ウイルス(HBV)陽性\n2:C型肝炎ウイルス(HCV)陽性\n3:B型肝炎ウイルス(HBV)及びC型肝炎ウイルス(HCV)ともに陽性\n4:B型肝炎ウイルス(HBV)及びC型肝炎ウイルス(HCV)ともに陰性"]
[null,"外傷の原因\n（主傷病名が外傷（中毒を含む）の場合のみ記入）",null,"＜不慮の事故＞　 1:自動車交通事故\n　　　　　　　　　　　　2:自転車交通事故\n　　　　　　　　　　　　3:その他の交通事故\n　　　　　　　　　　　　4:スポーツ中の事故\n　　　　　　　　　　　　5:転倒・転落\n　　　　　　　　　　　　6:1～5以外の原因による不慮の事故\n＜故意又は不明＞7:自傷\n　　　　　　　　　　　　8:他傷\n　　　　　　　　　　　　9:不明"]
[null,"(2)副傷病名\n（該当するものすべて）",null,"01:副傷病なし"]
[null,null,null,"02:糖尿病（合併症を伴わないもの）"]
[null,null,null,"03:糖尿病(性)腎症"]
[null,null,null,"04:糖尿病(性)眼合併症"]
[null,null,null,"05:糖尿病(性)神経障害"]
[null,null,null,"06:03～05以外の合併症を伴う糖尿病"]
[null,null,null,"07:肥満(症)"]
[null,null,null,"08:脂質異常症(高コレステロール血症等)"]
[null,null,null,"09:高血圧(症)"]
[null,null,null,"10:虚血性心疾患"]
[null,null,null,"11:脳卒中"]
[null,null,null,"12:閉塞性末梢動脈疾患"]
[null,null,null,"13:大動脈疾患(大動脈解離、大動脈瘤)"]
[null,null,null,"14:慢性腎臓病(慢性腎不全等)"]
[null,null,null,"15:精神疾患"]
[null,null,null,"16:その他の疾患"]
["(6)診療費等支払方法","負担区分\n（該当するものすべて）",null,"1:自費診療(保険外併用療養費を含む)"]
[null,null,null,"2:医療保険等、公費負担医療"]
[null,null,null,"3:介護保険(介護扶助を含む)"]
[null,"Ⅰ医療保険等\n（負担区分に「2.医療保険等、公費負担医療」がある場合は記入）",null,"1:健康保険・各種共済組合(本人)\n2:健康保険・各種共済組合(家族)\n3:国民健康保険\n4:高齢者医療(後期高齢者医療制度)\n5:労働災害・公務災害\n6:自動車損害賠償保障法\n7:その他"]
[null,"Ⅱ公費負担医療\n（負担区分に「2.医療保険等、公費負担医療」がある場合は該当するものすべて記入）",null,"08:感染症の予防及び感染症の患者に対する医療に関する法律"]
[null,null,null,"09:障害者の日常生活及び社会生活を総合的に支援するための法律(育成医療・更生医療)"]
[null,null,null,"10:生活保護法(医療扶助)"]
[null,null,null,"11:その他の公費負担によるもの"]
["(7)紹介の状況","紹介の状況",null,"1:病院から\n2:一般診療所から\n3:歯科診療所から\n4:介護医療院から\n5:介護老人保健施設から\n6:介護老人福祉施設から\n7:その他から\n8:紹介なし"]
["(8)来院時の状況","通常・救急",null,"＜通常の受診＞1:通常の受診\n＜救急の受診＞2:救急車により搬送\n　　　　　　　　　　 3:徒歩や自家用車等による救急の受診"]
[null,"救急診療時間\n（通常・救急が「２～３＜救急の受診＞」の場合のみ記入）",null,"1:診療時間内の受診\n2:診療時間外の受診"]
["(9)病床の種別","病床の種別",null,"1:療養病床\n2:一般病床"]
["(10)入院の状況","入院の状況",null,"1:生命の危険は少ないが入院治療を要する\n2:生命の危険がある\n3:受け入れ条件が整えば退院可能\n4:検査入院\n5:その他"]
[null,null,""]
[null,null,""]
[null,null,""]

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["・「入力のしかた」ボタンをクリックすると、選択している項目の入力のしかたが表示されます。"]
["・「テキストから読み込み」ボタンをクリックすると、外部テキストデータを読み込みます。\n　（事前に回答内容をテキストファイル形式で作成している場合は利用できます）\n・「取込データに出力」ボタンをクリックすると、入力した情報を取込データに出力します。\n・「取込データを追加」ボタンをクリックすると、現在の入力情報に取込データを追加します。\n　（取込データは複数人で入力作業を行った情報を統合させることが出来ます）\n・すべての入力が終わりましたら「エラーチェック・保存」ボタンをクリックしてください。"]
[]
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[null,null,null,null,null,null,null,null,null,null,"セル表示：","桃色→","エラー箇所を表示しています。"]
["患者番号","（1）","(2)出生年月日",null,null,null,"(3)患者の住所",null,"(4)入院年月日",null,null,null,"(5)受療の状況",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(6)診療費等支払方法",null,null,null,null,null,null,null,"（7）","(8)来院時の状況",null,"（9）","（10）"]
[null,"性別","1令和\n2平成\n3昭和\n4大正\n5明治\n\n※推定年齢を記入する場合は「入力のしかた」を参照","年","月","日","当院と\n同別",null,"1令和\n2平成\n3昭和","年","月","日","受療の状況","主傷病名","肝疾患の状況","外傷の原因","副傷病名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"紹介の状況","通常・救急","救急","病床の種別","入院の状況"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,"複数回答",null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,2,3,"Ⅰ医療保険等","Ⅱ　公費負担医療"]
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[null,"1 男\n2 女",null,null,null,null,"1 同　\n2 別","　　　都道府県",null,null,null,null,null,null,null,null,"副傷病なし","糖尿病\r\n(合併症を伴わないもの)","糖尿病（性）腎症","糖尿病（性）眼合併症","糖尿病（性）神経障害","03～05以外の合併症を伴う糖尿病","肥満（症）","脂質異常症（高コレステロール血症等）","高血圧（症）","虚血性心疾患","脳卒中","閉塞性末梢\n動脈疾患","大動脈疾患（大動脈解離、大動脈瘤）","慢性腎臓病（慢性腎不全等）","精神疾患","その他の疾患","自費診療（保険外併用療養費を含む）","医療保険等、\n公費負担医療","介護保険（介護扶助を含む）",null,"感染症法","障害者総合支援法","生活保護法","その他",null,null,null,null,null,"単記票データ","テキスト読","オンライン"]
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["フィールドID","記入のしかた（HTML）","項目名","表示範囲\n（先頭行）","表示範囲\n（後尾行）","単記票\n行位置","単記票\n列位置"]
[1,"●自動で採番されます。\n●入力不可です。\n","【患者番号】",8,null,7,2]
[2,"●性別を入力します。\n　　1又は2のいずれかを入力します。\n","【(1)性別】",8,null,8,2]
[3,"●出生年月日を入力します。\n　　「元号」は、1～5のいずれかを入力します。\n　　「年」「月」「日」は、数字を入力します。\n\n　　※生年月日が不明の場合は、「元号」「年」「月」「日」に9999を入力し、後ろ3桁に推定年齢を入力してください。\n　　　例）推定年齢が87歳の場合：「9999087」と入力。\n　　　（元号：9、年：99、月：9+年齢の百の位、日：年齢の後ろ2桁。）","【(2)出生年月日】",8,null,9,2]
[4,null,null,9,null,10,2]
[5,null,null,9,null,11,2]
[6,null,null,9,null,12,2]
[7,"●患者の住所を入力します。\n①　1又は2のいずれかを入力します。\n　1:当院と同じ都道府県内\n　2:当院とは別の都道府県\n\n②　①が「2:当院とは別の都道府県」の場合は、「都道府県」を漢字入力します。\n\n　　・外国人旅行者の場合は、①に「2」を入力し、②の「都道府県」に「外国」と入力してください。\n　　・住所不定又は不詳の場合は、①に「2」を入力し、②の「都道府県」に「不詳」と入力してください。","【(3)患者の住所】",8,null,13,2]
[8,null,null,8,null,14,2]
[9,"●入院年月日を入力します。\n　　「元号」は、1～3のいずれかを入力します。\n　　「年」「月」「日」は、数字を入力します。\n","【(4)入院年月日】",8,null,15,2]
[10,null,null,9,null,16,2]
[11,null,null,9,null,17,2]
[12,null,null,9,null,18,2]
[13,"●受療の状況を入力します。\n　　1～6のいずれかを入力します。\n　　1:傷病の診断・治療\n　　2:正常分娩(単胎自然分娩)\n　　3:正常妊娠・産じょくの管理\n　　4:健康者に対する検査・健康診断(査)・管理\n　　6:その他の保健サービス\n","【(5)受療の状況】",8,null,19,2]
[14,"●主傷病名を入力します。\n　　受療の状況が「1:傷病の診断・治療」の場合は、「主傷病名」を漢字入力します。\n\n　 ※主傷病名については、以下の内容もできるだけ入力してください。\n　　　　発病の型(例：急性・慢性　等)\n　　　　病因(例：アルコール性　等)\n　　　　部位(例：胃噴門部　等)\n　　　　性状(例：悪性　等)\n　　　　重症度（例：ステージ４　等）\n　　例：アルコール性　急性膵炎\n　　　　慢性腎臓病、ステージ４\n　　　　胃噴門部の悪性新生物\n　　　　未分化大細胞型リンパ腫、ALK陰性\n　　　　後天性　溶血性　貧血",null,8,null,20,2]
[15,"●肝疾患の状況を入力します。\n　  主傷病名が「慢性肝炎」、「肝硬変」又は「肝及び肝内胆管の悪性新生物」の場合は、1～4のいずれかを入力します。\n　　1:Ｂ型肝炎ウイルス(HBV)陽性\n　　2:Ｃ型肝炎ウイルス(HCV)陽性\n　　3:Ｂ型肝炎ウイルス(HBV)及びＣ型肝炎ウイルス(HCV)ともに陽性\n　　4:Ｂ型肝炎ウイルス(HBV)及びＣ型肝炎ウイルス(HCV)ともに陰性\n",null,8,null,21,2]
[16,"●外傷の原因を入力します。\n　  主傷病名が外傷（中毒を含む）の場合は、1～9のいずれかを入力します。\n　不慮の事故\n　　　1:自動車交通事故\n　　　2:自転車交通事故\n　　　3:その他の交通事故\n　　　4:スポーツ中の事故\n　　　5:転倒・転落\n　　　6:1～5以外の原因による不慮の事故\n　故意又は不明\n　　　7:自傷\n　　　8:他傷\n　　　9:不明\n",null,8,null,22,2]
[17,"●副傷病名を入力します。\n　  主傷病名以外の傷病について、該当する項目すべてに「1」を入力します。\n　　　01:副傷病なし\n　　　02:糖尿病(合併症を伴わないもの)\n　　　03:糖尿病(性)腎症\n　　　04:糖尿病(性)眼合併症\n　　　05:糖尿病(性)神経障害\n　　　06:03～05以外の合併症を伴う糖尿病\n　　　07:肥満(症)\n　　　08:脂質異常症(高コレステロール血症等)\n　　　09:高血圧(症) \n　　　10:虚血性心疾患　\n　　　11:脳卒中\n　　　12:閉塞性末梢動脈疾患\n　　　13:大動脈疾患(大動脈解離、大動脈瘤)\n　　　14:慢性腎臓病(慢性腎不全等)\n　　　15:精神疾患\n　　　16:その他の疾患\n\n　 ※「15:精神疾患」とは、以下の疾患をいいます。\n　　　　　・アルツハイマー病を含む認知症\n　　　　　・精神作用物質による精神及び行動の障害\n　　　　　・統合失調症、統合失調症型障害及び妄想性障害\n　　　　　・気分［感情］障害\n　　　　　・神経症性障害\n　　　　　・てんかん\n　　　　　・その他の精神及び行動の障害\n　　　（ただし、知的障害＜精神遅滞＞は除きます。）",null,8,null,23,2]
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[19,null,null,8,null,25,2]
[20,null,null,8,null,26,2]
[21,null,null,8,null,27,2]
[22,null,null,8,null,28,2]
[23,null,null,8,null,29,2]
[24,null,null,8,null,30,2]
[25,null,null,8,null,31,2]
[26,null,null,8,null,32,2]
[27,null,null,8,null,33,2]
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[33,"●診療費等支払方法を入力します。\n①　該当する項目すべてに「1」を入力します。\n　　1:自費診療(保険外併用療養費を含む)\n　　2:医療保険等、公費負担医療\n　　3:介護保険(介護扶助を含む)\n\n②　①が「2:医療保険等、公費負担医療」の場合は、\n　　　　「Ⅰ 医療保険等」については該当する数字を1つ入力し、\n　　　　「Ⅱ 公費負担医療」については該当する項目すべてに「1」を入力します。\n\n　Ⅰ 医療保険等\n　　 01:健康保険・各種共済組合(本人)\n　　 02:健康保険・各種共済組合(家族)\n　　 03:国民健康保険\n　　 04:高齢者医療（後期高齢者医療制度）\n　　 05:労働災害・公務災害\n　　 06:自動車損害賠償保障法\n　　 07:その他\n\n　Ⅱ 公費負担医療\n　　08:感染症の予防及び感染症の患者に対する医療に関する法律\n　　09:障害者の日常生活及び社会生活を総合的に支援するための法律（育成医療、更生医療）\n　　10:生活保護法（医療扶助）\n　　11:その他の公費負担によるもの\n\n　　※介護保険サービス利用者で、医療保険等と公費負担医療を併用している場合は、\n　　　 それらの両方について入力します。\n","【(6)診療費等支払方法】",8,null,39,2]
[34,null,null,8,null,40,2]
[35,null,null,null,null,41,2]
[36,null,null,8,null,42,2]
[37,null,null,8,null,43,2]
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[39,null,null,8,null,45,2]
[40,null,null,8,null,46,2]
[41,"●紹介の状況を入力します。\n　  1～8のいずれかを入力します。\n　1:病院から\n　2:一般診療所から\n　3:歯科診療所から\n　4:介護医療院から\n　5:介護老人保健施設から\n　6:介護老人福祉施設から\n　7:その他から\n　8:紹介なし","【(7)紹介の状況】",8,null,47,2]
[42,"●来院時の状況を入力します。\n①　1～3のいずれかを入力します。\n　1:通常の受診\n　救急の受診\n　2:救急車により搬送\n　3:徒歩や自家用車等による救急の受診\n\n②　①が「2:救急車により搬送」又は「3:徒歩や自家用車等による救急の受診」（救急の受診）の場合は、\n　　1又は2のいずれかを入力します。\n　1:診療時間内の受診\n　2:診療時間外の受診\n","【(8)来院時の状況】",8,null,48,2]
[43,null,null,8,null,49,2]
[44,"●病床の種別を入力します。\n　  1～2のいずれかを入力します。\n　1:療養病床\n　2:一般病床\n　","【(9)病床の種別】",8,null,50,2]
[45,"●入院の状況を入力します。\n　  調査日現在の状況について、1～5のいずれかを入力します。\n　1:生命の危険は少ないが入院治療を要する\n　2:生命の危険がある\n　3:受け入れ条件が整えば退院可能\n　4:検査入院\n　5:その他\n\n","【(10)入院の状況】",8,null,51,2]

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[2,"(1)性別",null,null,"B8",null,"○","数字",1,1,2,null,null,null,null,"C8"]
[3,"(2)出生年月日","元号",null,"B9",null,"○","数字",1,1,9,null,null,null,null,"C9"]
[4,"(2)出生年月日","年",null,"B10",null,"○","数字",2,1,99,null,null,null,null,"C10"]
[5,"(2)出生年月日","月",null,"B11",null,"○","数字",2,1,91,null,null,null,null,"C11"]
[6,"(2)出生年月日","日",null,"B12",null,"○","数字",2,0,99,null,null,null,null,"C12"]
[7,"(3)患者の住所","当院と同別",null,"B13",null,"○","数字",1,1,2,null,null,null,null,"C13"]
[8,"(3)患者の住所","都道府県",null,"B14",null,null,"全角",4,null,null,null,null,null,null,"C14"]
[9,"(4)入院年月日","元号",null,"B15",null,"○","数字",1,1,3,null,null,null,null,"C15"]
[10,"(4)入院年月日","年",null,"B16",null,"○","数字",2,1,64,null,null,null,null,"C16"]
[11,"(4)入院年月日","月",null,"B17",null,"○","数字",2,1,12,null,null,null,null,"C17"]
[12,"(4)入院年月日","日",null,"B18",null,"○","数字",2,1,31,null,null,null,null,"C18"]
[13,"(5)受療の状況","受療の状況",null,"B19",null,"○","数字",1,1,6,null,null,null,null,"C19"]
[14,"(5)受療の状況","主傷病名",null,"B20",null,null,"全角",40,null,null,null,null,null,null,"C20"]
[15,"(5)受療の状況","肝疾患の状況",null,"B21",null,null,"数字",1,1,4,null,null,null,null,"C21"]
[16,"(5)受療の状況","外傷の原因",null,"B22",null,null,"数字",1,1,9,null,null,null,null,"C22"]
[17,"(5)受療の状況","01:副傷病なし",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C23"]
[18,"(5)受療の状況","02:糖尿病（合併症なし）",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C24"]
[19,"(5)受療の状況","03:糖尿病(性)腎症",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C25"]
[20,"(5)受療の状況","04:糖尿病(性)眼合併症",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C26"]
[21,"(5)受療の状況","05:糖尿病(性)神経障害",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C27"]
[22,"(5)受療の状況","06:03～05以外の合併症を伴う糖尿病",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C28"]
[23,"(5)受療の状況","07:肥満(症) ",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C29"]
[24,"(5)受療の状況","08:脂質異常症(高コレステロール血症等)",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C30"]
[25,"(5)受療の状況","09:高血圧(症)",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C31"]
[26,"(5)受療の状況","10:虚血性心疾患",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C32"]
[27,"(5)受療の状況","11:脳卒中",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C33"]
[28,"(5)受療の状況","12:閉塞性末梢動脈疾患",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C34"]
[29,"(5)受療の状況","13:大動脈疾患(大動脈解離、大動脈瘤)",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C35"]
[30,"(5)受療の状況","14:慢性腎臓病(慢性腎不全等)",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C36"]
[31,"(5)受療の状況","15:精神疾患",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C37"]
[32,"(5)受療の状況","16:その他の疾患",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C38"]
[33,"(6)診療費等支払方法","自費診療",null,"B39",null,null,"数字",1,1,1,null,null,null,null,"C39"]
[34,"(6)診療費等支払方法","医療・公費",null,"B39",null,null,"数字",1,1,1,null,null,null,null,"C40"]
[35,"(6)診療費等支払方法","介護保険",null,"B39",null,null,"数字",1,1,1,null,null,null,null,"C41"]
[36,"(6)診療費等支払方法","Ⅰ医療保険等",null,"B42",null,null,"数字",1,1,7,null,null,null,null,"C42"]
[37,"(6)診療費等支払方法","Ⅱ公費負担医療","08感染症法","B43",null,null,"数字",1,1,1,null,null,null,null,"C43"]
[38,"(6)診療費等支払方法","Ⅱ公費負担医療","09障害者法","B43",null,null,"数字",1,1,1,null,null,null,null,"C44"]
[39,"(6)診療費等支払方法","Ⅱ公費負担医療","10生活保護法（医療扶助）","B43",null,null,"数字",1,1,1,null,null,null,null,"C45"]
[40,"(6)診療費等支払方法","Ⅱ公費負担医療","11その他の公費負担によるもの","B43",null,null,"数字",1,1,1,null,null,null,null,"C46"]
[41,"(7)紹介の状況",null,null,"B47",null,"○","数字",1,1,8,null,null,null,null,"C47"]
[42,"(8)来院時の状況","通常・救急",null,"B48",null,"○","数字",1,1,3,null,null,null,null,"C48"]
[43,"(8)来院時の状況","診療時間",null,"B49",null,null,"数字",1,1,2,null,null,null,null,"C49"]
[44,"(9)病床の種別",null,null,"B50",null,"○","数字",1,1,2,null,null,null,null,"C50"]
[45,"(10)入院の状況",null,null,"B51",null,"○","数字",1,1,5,null,null,null,null,"C51"]

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[null,null,null,"・「入力のしかた」ボタンをクリックすると、選択している項目の入力のしかたが表示されます。"]
[null,null,null,"・すべての入力が終わりましたら「エラーチェック・保存」ボタンをクリックしてください。"]
[null,null,null,"・セル表示：桃色　 → エラー箇所を表示しています。"]
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[]
["項目名",null,"入力欄","凡例（選択項目（数字を入力する項目）は半角英数字で入力してください）"]
["患者番号（自動入力）",null,{"$f":"F7","v":"0001"},null,null,"0001"]
["(1)性別","性別",null,"1:男　2:女"]
["(2)出生年月日","元号","","1:令和　2:平成　3:昭和　4:大正　5:明治　※推定年齢を記入する場合は「入力のしかた」を参照"]
[null,"年","","1～99"]
[null,"月","","1～91"]
[null,"日","","0～99"]
["(3)患者の住所","当院と同別","","1:当院と同じ都道府県内　2:当院とは別の都道府県"]
[null,"都道府県\n（当院と同別が「２：当院とは別の都道府県」の場合のみ記入）",null,"全角４文字以内で入力してください"]
["(4)外来の種別","初診","","1:通院\n2:往診"]
[null,"再来","","3:通院\n4:往診\n5:訪問診療\n6:医師以外の訪問"]
[null,"「3」～「6」の場合は、月を記入してください。\n前回診療月日又は前回訪問月日\n令和8年　月　日\n（外来の種別が再来の場合）","","1～10"]
[null,"「3」～「6」の場合は、日を記入してください。\n前回診療月日又は前回訪問月日\n令和8年　月　日\n（外来の種別が再来の場合）","","1～31"]
["(5)受療の状況","受療の状況\n（2～6を選択した場合、 「（6）診療費等支払方法」の入力へ進む）\n","","1:傷病の診断・治療\n2:正常分娩(単胎自然分娩)\n3:正常妊娠・産じょくの管理\n4:健康者に対する検査、健康診断(査)・管理\n5:予防接種\n6:その他の保健サービス"]
[null,"(1)主傷病名\n（受療の状況が「1.傷病の診断・治療」の場合のみ記入）","","全角４０文字以内で入力してください"]
[null,"肝疾患の状況\n（主傷病名が「慢性肝炎」、「肝硬変」又は「肝及び肝内胆管の悪性新生物」の場合のみ記入）","","1:B型肝炎ウイルス(HBV)陽性\n2:C型肝炎ウイルス(HCV)陽性\n3:B型肝炎ウイルス(HBV)及びC型肝炎ウイルス(HCV)ともに陽性\n4:B型肝炎ウイルス(HBV)及びC型肝炎ウイルス(HCV)ともに陰性"]
[null,"外傷の原因\n（主傷病名が外傷（中毒を含む）の場合のみ記入）","","＜不慮の事故＞　 1:自動車交通事故\n　　　　　　　　　　　　2:自転車交通事故\n　　　　　　　　　　　　3:その他の交通事故\n　　　　　　　　　　　　4:スポーツ中の事故\n　　　　　　　　　　　　5:転倒・転落\n　　　　　　　　　　　　6:1～5以外の原因による不慮の事故\n＜故意又は不明＞7:自傷\n　　　　　　　　　　　　8:他傷\n　　　　　　　　　　　　9:不明"]
[null,"(2)副傷病名\n（該当するものすべて）","","01:副傷病なし"]
[null,null,"","02:糖尿病（合併症を伴わないもの）"]
[null,null,"","03:糖尿病(性)腎症"]
[null,null,"","04:糖尿病(性)眼合併症"]
[null,null,"","05:糖尿病(性)神経障害"]
[null,null,"","06:03～05以外の合併症を伴う糖尿病"]
[null,null,"","07:肥満(症)"]
[null,null,"","08:脂質異常症(高コレステロール血症等)"]
[null,null,"","09:高血圧(症)"]
[null,null,"","10:虚血性心疾患"]
[null,null,"","11:脳卒中"]
[null,null,"","12:閉塞性末梢動脈疾患"]
[null,null,"","13:大動脈疾患(大動脈解離、大動脈瘤)"]
[null,null,"","14:慢性腎臓病(慢性腎不全等)"]
[null,null,"","15:精神疾患"]
[null,null,"","16:その他の疾患"]
["(6)診療費等支払方法","負担区分\n（該当するものすべて）","","1:自費診療(保険外併用療養費を含む)"]
[null,null,null,"2:医療保険等、公費負担医療"]
[null,null,"","3:介護保険(介護扶助を含む)"]
[null,"Ⅰ医療保険等\n（負担区分に「2.医療保険等、公費負担医療」がある場合は記入）","","1:健康保険・各種共済組合(本人)\n2:健康保険・各種共済組合(家族)\n3:国民健康保険\n4:高齢者医療(後期高齢者医療制度)\n5:労働災害・公務災害\n6:自動車損害賠償保障法\n7:その他"]
[null,"Ⅱ公費負担医療\n（負担区分に「2.医療保険等、公費負担医療」がある場合は該当するものすべて記入）","","08:感染症の予防及び感染症の患者に対する医療に関する法律"]
[null,null,"","09:障害者の日常生活及び社会生活を総合的に支援するための法律(育成医療・更生医療・精神通院医療)"]
[null,null,"","10:生活保護法(医療扶助)"]
[null,null,"","11:その他の公費負担によるもの"]
["(7)紹介の状況","紹介の状況","","1:病院から\n2:一般診療所から\n3:歯科診療所から\n4:介護医療院から\n5:介護老人保健施設から\n6:介護老人福祉施設から\n7:その他から\n8:紹介なし"]
["(8)来院時の状況","通常・救急","","＜通常の受診＞1:通常の受診\n＜救急の受診＞2:救急車により搬送\n　　　　　　　　　　 3:徒歩や自家用車等による救急の受診"]
[null,"救急診療時間\n（通常・救急が「２～３＜救急の受診＞」の場合のみ記入）","","1:診療時間内の受診\n2:診療時間外の受診"]
[null,null,""]
[null,null,""]
[null,null,""]
[null,null,""]
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["・「入力のしかた」ボタンをクリックすると、選択している項目の入力のしかたが表示されます。"]
["・「テキストから読み込み」ボタンをクリックすると、外部テキストデータを読み込みます。\n　（事前に回答内容をテキストファイル形式で作成している場合は利用できます）\n・「取込データに出力」ボタンをクリックすると、入力した情報を取込データに出力します。\n・「取込データを追加」ボタンをクリックすると、現在の入力情報に取込データを追加します。\n　（取込データは複数人で入力作業を行った情報を統合させることが出来ます）\n・すべての入力が終わりましたら「エラーチェック・保存」ボタンをクリックしてください。"]
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[null,null,null,null,null,null,null,null,null,null,"セル表示：","桃色→","エラー箇所を表示しています。"]
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[null,"性別","1令和\n2平成\n3昭和\n4大正\n5明治\n\n※推定年齢を記入する場合は「入力のしかた」を参照","年","月","日","当院と\n同別",null,"初診","再来",null,null,"受療の状況","主傷病名","肝疾患の状況","外傷の原因","副傷病名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"紹介の状況","通常・救急","救急"]
[null,null,null,null,null,null,null,null,null,null,"「3」～「6」の場合は、月日を記入してください。\n前回診療月日又は前回訪問月日\n令和8年",null,null,null,null,null,1,"複数回答",null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,2,3,"Ⅰ医療保険等","Ⅱ　公費負担医療"]
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["ID","項目名",null,null,null,"属性",null,null,null,null,null,null,null,null,null,"単記票\nセル位置"]
[null,1,2,3,4,"読取専用","必須","混在","桁数","最小値","最大値","真偽値","全角","半角","コントロール"]
[1,"患者番号",null,null,"A7","○",null,null,null,1,9999,null,null,null,null,"C7"]
[2,"(1)性別",null,null,"B8",null,"○","数字",1,1,2,null,null,null,null,"C8"]
[3,"(2)出生年月日","元号",null,"B9",null,"○","数字",1,1,9,null,null,null,null,"C9"]
[4,"(2)出生年月日","年",null,"B10",null,"○","数字",2,1,99,null,null,null,null,"C10"]
[5,"(2)出生年月日","月",null,"B11",null,"○","数字",2,1,91,null,null,null,null,"C11"]
[6,"(2)出生年月日","日",null,"B12",null,"○","数字",2,0,99,null,null,null,null,"C12"]
[7,"(3)患者の住所","当院と同別",null,"B13",null,"○","数字",1,1,2,null,null,null,null,"C13"]
[8,"(3)患者の住所","都道府県",null,"B14",null,null,"全角",4,null,null,null,null,null,null,"C14"]
[9,"(4)外来の種別","初診",null,"B15",null,null,"数字",1,1,2,null,null,null,null,"C15"]
[10,"(4)外来の種別","再来",null,"B16",null,null,"数字",1,3,6,null,null,null,null,"C16"]
[11,"(4)外来の種別","前回診療（訪問）","月","B17",null,null,"数字",2,1,10,null,null,null,null,"C17"]
[12,"(4)外来の種別","前回診療（訪問）","日","B18",null,null,"数字",2,1,31,null,null,null,null,"C18"]
[13,"(5)受療の状況","受療の状況",null,"B19",null,"○","数字",1,1,6,null,null,null,null,"C19"]
[14,"(5)受療の状況","主傷病名",null,"B20",null,null,"全角",40,null,null,null,null,null,null,"C20"]
[15,"(5)受療の状況","肝疾患の状況",null,"B21",null,null,"数字",1,1,4,null,null,null,null,"C21"]
[16,"(5)受療の状況","外傷の原因",null,"B22",null,null,"数字",1,1,9,null,null,null,null,"C22"]
[17,"(5)受療の状況","01:副傷病なし",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C23"]
[18,"(5)受療の状況","02:糖尿病（合併症なし）",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C24"]
[19,"(5)受療の状況","03:糖尿病(性)腎症",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C25"]
[20,"(5)受療の状況","04:糖尿病(性)眼合併症",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C26"]
[21,"(5)受療の状況","05:糖尿病(性)神経障害",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C27"]
[22,"(5)受療の状況","06:03～05以外の合併症を伴う糖尿病",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C28"]
[23,"(5)受療の状況","07:肥満(症) ",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C29"]
[24,"(5)受療の状況","08:脂質異常症(高コレステロール血症等)",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C30"]
[25,"(5)受療の状況","09:高血圧(症)",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C31"]
[26,"(5)受療の状況","10:虚血性心疾患",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C32"]
[27,"(5)受療の状況","11:脳卒中",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C33"]
[28,"(5)受療の状況","12:閉塞性末梢動脈疾患",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C34"]
[29,"(5)受療の状況","13:大動脈疾患(大動脈解離、大動脈瘤)",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C35"]
[30,"(5)受療の状況","14:慢性腎不全(慢性腎臓病)",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C36"]
[31,"(5)受療の状況","15:精神疾患",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C37"]
[32,"(5)受療の状況","16:その他の疾患",null,"B23",null,null,"数字",1,1,1,null,null,null,null,"C38"]
[33,"(6)診療費等支払方法","自費診療",null,"B39",null,null,"数字",1,1,1,null,null,null,null,"C39"]
[34,"(6)診療費等支払方法","医療・公費",null,"B39",null,null,"数字",1,1,1,null,null,null,null,"C40"]
[35,"(6)診療費等支払方法","介護保険",null,"B39",null,null,"数字",1,1,1,null,null,null,null,"C41"]
[36,"(6)診療費等支払方法","Ⅰ医療保険等",null,"B42",null,null,"数字",1,1,7,null,null,null,null,"C42"]
[37,"(6)診療費等支払方法","Ⅱ公費負担医療","08感染症法","B43",null,null,"数字",1,1,1,null,null,null,null,"C43"]
[38,"(6)診療費等支払方法","Ⅱ公費負担医療","09障害者法","B43",null,null,"数字",1,1,1,null,null,null,null,"C44"]
[39,"(6)診療費等支払方法","Ⅱ公費負担医療","10生活保護法（医療扶助）","B43",null,null,"数字",1,1,1,null,null,null,null,"C45"]
[40,"(6)診療費等支払方法","Ⅱ公費負担医療","11その他の公費負担によるもの","B43",null,null,"数字",1,1,1,null,null,null,null,"C46"]
[41,"(7)紹介の状況",null,null,"B47",null,"○","数字",1,1,8,null,null,null,null,"C47"]
[42,"(8)来院時の状況","通常・救急",null,"B48",null,"○","数字",1,1,3,null,null,null,null,"C48"]
[43,"(8)来院時の状況","診療時間",null,"B49",null,null,"数字",1,1,2,null,null,null,null,"C49"]

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["フィールドID","記入のしかた（HTML）","項目名","表示範囲\n（先頭行）","表示範囲\n（後尾行）","単記票\n行位置","単記票\n列位置"]
[1,"●自動で採番されます。\n●入力不可です。\n","【患者番号】",8,null,7,2]
[2,"●性別を入力します。\n　　1又は2のいずれかを入力します。\n","【(1)性別】",8,null,8,2]
[3,"●出生年月日を入力します。\n　　「元号」は、1～5のいずれかを入力します。\n　　「年」「月」「日」は、数字を入力します。\n\n　　※生年月日が不明の場合は、「元号」「年」「月」「日」に9999を入力し、後ろ3桁に推定年齢を入力してください。\n　　　例）推定年齢が87歳の場合：「9999087」と入力。\n　　　（元号：9、年：99、月：9+年齢の百の位、日：年齢の後ろ2桁。）","【(2)出生年月日】",8,null,9,2]
[4,null,null,9,null,10,2]
[5,null,null,9,null,11,2]
[6,null,null,9,null,12,2]
[7,"●患者の住所を入力します。\n①　1又は2のいずれかを入力します。\n　1:当院と同じ都道府県内\n　2:当院とは別の都道府県\n\n②　①が「2:当院とは別の都道府県」の場合は、「都道府県」を漢字入力します。\n\n　　・外国人旅行者の場合は、①に「2」を入力し、②の「都道府県」に「外国」と入力してください。\n　　・住所不定又は不詳の場合は、①に「2」を入力し、②の「都道府県」に「不詳」と入力してください。","【(3)患者の住所】",8,null,13,2]
[8,null,null,9,null,14,2]
[9,"●外来の種別を入力します。\n①　1～6のいずれかを入力します。\n\n②　①が「再来」（「3」～「6」）の場合、「前回診療月日」又は「前回訪問月日」を入力します。\n     「月」「日」は、数字を入力します。\n","【(4)外来の種別】",8,null,15,2]
[10,null,null,9,null,16,2]
[11,null,null,9,null,17,2]
[12,null,null,9,null,18,2]
[13,"●受療の状況を入力します。\n　　1～6のいずれかを入力します。\n　　1:傷病の診断・治療\n　　2:正常分娩(単胎自然分娩)\n　　3:正常妊娠・産じょくの管理\n　　4:健康者に対する検査・健康診断(査)・管理\n　　5:予防接種\n　　6:その他の保健サービス\n","【(5)受療の状況】",8,null,19,2]
[14,"●主傷病名を入力します。\n　　受療の状況が「1:傷病の診断・治療」の場合は、「主傷病名」を漢字入力します。\n\n　 ※主傷病名については、以下の内容もできるだけ入力してください。\n　　　　発病の型(例：急性・慢性　等)\n　　　　病因(例：アルコール性　等)\n　　　　部位(例：胃噴門部　等)\n　　　　性状(例：悪性　等)\n　　　　重症度（例：ステージ４　等）\n　　例：アルコール性　急性膵炎\n　　　　慢性腎臓病、ステージ４\n　　　　胃噴門部の悪性新生物\n　　　　未分化大細胞型リンパ腫、ALK陰性\n　　　　後天性　溶血性　貧血",null,8,null,20,2]
[15,"●肝疾患の状況を入力します。\n　  主傷病名が「慢性肝炎」、「肝硬変」又は「肝及び肝内胆管の悪性新生物」の場合は、1～4のいずれかを入力します。\n　　1:Ｂ型肝炎ウイルス(HBV)陽性\n　　2:Ｃ型肝炎ウイルス(HCV)陽性\n　　3:Ｂ型肝炎ウイルス(HBV)及びＣ型肝炎ウイルス(HCV)ともに陽性\n　　4:Ｂ型肝炎ウイルス(HBV)及びＣ型肝炎ウイルス(HCV)ともに陰性\n",null,8,null,21,2]
[16,"●外傷の原因を入力します。\n　  主傷病名が外傷（中毒を含む）の場合は、1～9のいずれかを入力します。\n　不慮の事故\n　　　1:自動車交通事故\n　　　2:自転車交通事故\n　　　3:その他の交通事故\n　　　4:スポーツ中の事故\n　　　5:転倒・転落\n　　　6:1～5以外の原因による不慮の事故\n　故意又は不明\n　　　7:自傷\n　　　8:他傷\n　　　9:不明",null,8,null,22,2]
[17,"●副傷病名を入力します。\n　  主傷病名以外の傷病について、該当する項目すべてに「1」を入力します。\n　　　01:副傷病なし\n　　　02:糖尿病(合併症を伴わないもの)\n　　　03:糖尿病(性)腎症\n　　　04:糖尿病(性)眼合併症\n　　　05:糖尿病(性)神経障害\n　　　06:03～05以外の合併症を伴う糖尿病\n　　　07:肥満(症)\n　　　08:脂質異常症(高コレステロール血症等)\n　　　09:高血圧(症) \n　　　10:虚血性心疾患　\n　　　11:脳卒中\n　　　12:閉塞性末梢動脈疾患\n　　　13:大動脈疾患(大動脈解離、大動脈瘤)\n　　　14:慢性腎臓病(慢性腎不全等)\n　　　15:精神疾患\n　　　16:その他の疾患\n\n　 ※「15:精神疾患」とは、以下の疾患をいいます。\n　　　　　・アルツハイマー病を含む認知症\n　　　　　・精神作用物質による精神及び行動の障害\n　　　　　・統合失調症、統合失調症型障害及び妄想性障害\n　　　　　・気分［感情］障害\n　　　　　・神経症性障害\n　　　　　・てんかん\n　　　　　・その他の精神及び行動の障害\n　　　（ただし、知的障害＜精神遅滞＞は除きます。）\n",null,8,null,23,2]
[18,null,null,8,null,24,2]
[19,null,null,8,null,25,2]
[20,null,null,8,null,26,2]
[21,null,null,8,null,27,2]
[22,null,null,8,null,28,2]
[23,null,null,8,null,29,2]
[24,null,null,8,null,30,2]
[25,null,null,8,null,31,2]
[26,null,null,8,null,32,2]
[27,null,null,8,null,33,2]
[28,null,null,8,null,34,2]
[29,null,null,8,null,35,2]
[30,null,null,8,null,36,2]
[31,null,null,8,null,37,2]
[32,null,null,8,null,38,2]
[33,"●診療費等支払方法を入力します。\n①　該当する項目すべてに「1」を入力します。\n　　1:自費診療(保険外併用療養費を含む)\n　　2:医療保険等、公費負担医療\n　　3:介護保険(介護扶助を含む)\n\n②　①が「2:医療保険等、公費負担医療」の場合は、\n　　　　「Ⅰ 医療保険等」については該当する数字を1つ入力し、\n　　　　「Ⅱ 公費負担医療」については該当する項目すべてに「1」を入力します。\n\n　Ⅰ 医療保険等\n　　 01:健康保険・各種共済組合(本人)\n　　 02:健康保険・各種共済組合(家族)\n　　 03:国民健康保険\n　　 04:高齢者医療（後期高齢者医療制度）\n　　 05:労働災害・公務災害\n　　 06:自動車損害賠償保障法\n　　 07:その他\n\n　Ⅱ 公費負担医療\n　　08:感染症の予防及び感染症の患者に対する医療に関する法律\n　　09:障害者の日常生活及び社会生活を総合的に支援するための法律（育成医療、更生医療、精神通院医療）\n　　10:生活保護法（医療扶助）\n　　11:その他の公費負担によるもの\n\n　　　※介護保険サービス利用者で、医療保険等と公費負担医療を併用している場合は、\n　　　　 それらの両方について入力します。\n","【(6)診療費等支払方法】",8,null,39,2]
[34,null,null,8,null,40,2]
[35,null,null,null,null,41,2]
[36,null,null,8,null,42,2]
[37,null,null,8,null,43,2]
[38,null,null,8,null,44,2]
[39,null,null,8,null,45,2]
[40,null,null,8,null,46,2]
[41,"●紹介の状況を入力します。\n　  1～8のいずれかを入力します。\n　1:病院から\n　2:一般診療所から\n　3:歯科診療所から\n　4:介護医療院から\n　5:介護老人保健施設から\n　6:介護老人福祉施設から\n　7:その他から\n　8:紹介なし","【(7)紹介の状況】",8,null,47,2]
[42,"●来院時の状況を入力します。\n①　1～3のいずれかを入力します。\n　1:通常の受診\n　救急の受診\n　2:救急車により搬送\n　3:徒歩や自家用車等による救急の受診\n\n②　①が「2:救急車により搬送」又は「3:徒歩や自家用車等による救急の受診」（救急の受診）の場合は、\n　　1又は2のいずれかを入力します。\n　1:診療時間内の受診\n　2:診療時間外の受診\n","【(8)来院時の状況】",8,null,48,2]
[43,null,null,8,null,49,2]

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[null,null,null,"・「入力のしかた」ボタンをクリックすると、選択している項目の入力のしかたが表示されます。"]
[null,null,null,"・すべての入力が終わりましたら「エラーチェック・保存」ボタンをクリックしてください。"]
[null,null,null,"・セル表示：桃色　 → エラー箇所を表示しています。"]
[]
[]
["項目名",null,"入力欄","凡例（選択項目（数字を入力する項目）は半角英数字で入力してください）"]
["患者番号（自動入力）",null,{"$f":"F7","v":"0001"},null,null,"0001"]
["(1)性別","性別",null,"1:男　2:女"]
["(2)出生年月日","元号",null,"1:令和　2:平成　3:昭和　4:大正　5:明治　※推定年齢を記入する場合は「入力のしかた」を参照"]
[null,"年",null,"1～99"]
[null,"月",null,"1～91"]
[null,"日",null,"0～99"]
["(3)患者の住所","当院と同別",null,"1:当院と同じ都道府県内　2:当院とは別の都道府県"]
[null,"都道府県\n（当院と同別が「２：当院とは別の都道府県」の場合のみ記入）",null,"全角４文字以内で入力してください"]
["(4)過去の入院の有無","有無",null,"1:有　2:無"]
[null,"退院年月日　\n令和　平成\n（過去の入院の有無が「１：有」の場合）",null,"1:令和　2:平成"]
[null,null,null,"年:1～31"]
[null,null,null,"月:1～12"]
[null,null,null,"日:1～31"]
["(5)入院年月日","元号",null,"1:令和　2平成　3:昭和"]
[null,"年",null,"1～64"]
[null,"月",null,"1～12"]
[null,"日",null,"1～31"]
["(6)退院年月日","令和8年9月",null,"日:1～30"]
["(7)受療の状況","受療の状況\n（2～5を選択した場合、 「（8）診療費等支払方法」の入力へ進む）\n",null,"1:傷病の診断・治療\n2:正常分娩(単胎自然分娩)\n3:正常妊娠・産じょくの管理\n4:健康者に対する検査、健康診断(査)・管理\n5:その他の保健サービス"]
[null,"(1)主傷病名\n（受療の状況が「1.傷病の診断・治療」の場合のみ記入）",null,"全角４０文字以内で入力してください"]
[null,"外傷の原因\n（主傷病名が外傷（中毒を含む）の場合のみ記入）",null,"＜不慮の事故＞　 1:自動車交通事故\n　　　　　　　　　　　　2:自転車交通事故\n　　　　　　　　　　　　3:その他の交通事故\n　　　　　　　　　　　　4:スポーツ中の事故\n　　　　　　　　　　　　5:転倒・転落\n　　　　　　　　　　　　6:1～5以外の原因による不慮の事故\n＜故意又は不明＞7:自傷\n　　　　　　　　　　　　8:他傷\n　　　　　　　　　　　　9:不明"]
[null,"(2)副傷病名\n（該当するものすべて）",null,"01:副傷病なし"]
[null,null,null,"02:糖尿病(合併症を伴わないもの)"]
[null,null,null,"03:糖尿病(性)腎症"]
[null,null,null,"04:糖尿病(性)眼合併症"]
[null,null,null,"05:糖尿病(性)神経障害"]
[null,null,null,"06:03～05以外の合併症を伴う糖尿病"]
[null,null,null,"07:肥満(症)"]
[null,null,null,"08:脂質異常症(高コレステロール血症等)"]
[null,null,null,"09:高血圧(症)"]
[null,null,null,"10:虚血性心疾患"]
[null,null,null,"11:脳卒中"]
[null,null,null,"12:閉塞性末梢動脈疾患"]
[null,null,null,"13:大動脈疾患(大動脈解離、大動脈瘤)"]
[null,null,null,"14:慢性腎臓病(慢性腎不全等)"]
[null,null,null,"15:精神疾患"]
[null,null,null,"16:その他の疾患"]
["(8)診療費等支払方法","負担区分\n（該当するものすべて）",null,"1:自費診療(保険外併用療養費を含む)"]
[null,null,null,"2:医療保険等、公費負担医療"]
[null,null,null,"3:介護保険(介護扶助を含む)"]
[null,"Ⅰ医療保険等\n（負担区分に「2.医療保険等、公費負担医療」がある場合は記入）",null,"1:健康保険・各種共済組合(本人)\n2:健康保険・各種共済組合(家族)\n3:国民健康保険\n4:高齢者医療(後期高齢者医療制度)\n5:労働災害・公務災害\n6:自動車損害賠償保障法\n7:その他"]
[null,"Ⅱ公費負担医療\n（負担区分に「2.医療保険等、公費負担医療」がある場合は該当するものすべて記入）",null,"08:感染症の予防及び感染症の患者に対する医療に関する法律"]
[null,null,null,"09:障害者の日常生活及び社会生活を総合的に支援するための法律(育成医療・更生医療)"]
[null,null,null,"10:生活保護法(医療扶助)"]
[null,null,null,"11:その他の公費負担によるもの"]
["(9)病床の種別","病床の種別",null,"1:療養病床\n2:一般病床"]
["(10)入院前の場所","入院前の場所\n（家庭）　1～4\n\n（他の病院・診療所に入院）　5～7\n\n（その他）　8～12",null," 1:当院に通院\n 2:他の病院・診療所に通院\n 3:在宅医療（訪問診療 ・ 訪問看護等）\n 4:その他\n\n 5:地域医療支援病院 ・ 特定機能病院\n 6:その他の病院\n 7:診療所\n\n 8:介護医療院に入所\n 9:介護老人保健施設に入所\n10:介護老人福祉施設に入所\n11:社会福祉施設に入所\n12:その他 （新生児 ・ 不明等）"]
["(11)来院時の状況","通常・救急",null,"＜通常の受診＞1:通常の受診\n＜救急の受診＞2:救急車により搬送\n　　　　　　　　　　 3:徒歩や自家用車等による救急の受診"]
[null,"救急診療時間\n（通常・救急が「２～３＜救急の受診＞」の場合のみ記入）",null,"1:診療時間内の受診\n2:診療時間外の受診"]
["(12)手術の有無","有無",null,"1:有　2:無"]
[null,"手術日\n令和　平成\n（手術の有無が「１：有」の場合のみ記入）",null,"1:令和　2:平成"]
[null,null,null,"年:1～31"]
[null,null,null,"月:1～12"]
[null,null,null,"日:1～31"]
["(13)転帰","転帰",null,"1:治癒\n2:軽快\n3:不変\n4:悪化\n5:死亡\n6:その他\n"]
["(14)退院後の行き先\n\n「（13）転帰」で「5 死亡」の場合は記入の必要はありません。","退院後の行き先\n（家庭）　1～4\n\n（他の病院・診療所に入院）　5～7\n\n（その他）  8～12\n",null," 1:当院に通院\n 2:他の病院・診療所に通院\n 3:在宅医療（訪問診療 ・ 訪問看護等）\n 4:その他\n\n 5:地域医療支援病院 ・ 特定機能病院\n 6:その他の病院\n 7:診療所\n\n 8:介護医療院に入所\n 9:介護老人保健施設に入所\n10:介護老人福祉施設に入所\n11:社会福祉施設に入所\n12:その他 （不明等）"]
[null,null,""]
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[null,null,""]
[]
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["・「入力のしかた」ボタンをクリックすると、選択している項目の入力のしかたが表示されます。"]
["・「テキストから読み込み」ボタンをクリックすると、外部テキストデータを読み込みます。\n　（事前に回答内容をテキストファイル形式で作成している場合は利用できます）\n・「取込データに出力」ボタンをクリックすると、入力した情報を取込データに出力します。\n・「取込データを追加」ボタンをクリックすると、現在の入力情報に取込データを追加します。\n　（取込データは複数人で入力作業を行った情報を統合させることが出来ます）\n・すべての入力が終わりましたら「エラーチェック・保存」ボタンをクリックしてください。"]
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[null,null,null,null,null,null,null,null,null,null,null,"セル表示：","桃色→","エラー箇所を表示しています。"]
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[null,null,null,null,null,null,null,null,"2 無","退院年月日 令和 平成",null,null,null,null,null,null,null,null,null,null,null,null,"02","03","04","05","06","07","08","09","10","11","12","13","14","15","16",null,null,null,null,"08","09","10","11",null,null,null,"診療時間","2 無","手術日　令和　平成"]
[null,"1 男\n2 女",null,null,null,null,"1 同　\n2 別","　　　都道府県","\n","1令和\n2平成","年","月","日",null,null,null,null,null,null,null,null,"副傷病なし","糖尿病\r\n(合併症を伴わないもの)","糖尿病（性）腎症","糖尿病（性）眼合併症","糖尿病（性）神経障害","03～05以外の合併症を伴う糖尿病","肥満（症）","脂質異常症（高コレステロール血症等）","高血圧（症）","虚血性心疾患","脳卒中","閉塞性末梢\n動脈疾患","大動脈疾患（大動脈解離、大動脈瘤）","慢性腎臓病（慢性腎不全等）","精神疾患","その他の疾患","自費診療（保険外併用療養費を含む）","医療保険等、\n公費負担医療","介護保険（介護扶助を含む）",null,"感染症法","障害者総合支援法","生活保護法","その他",null,null,null,null,"\n","1令和\n2平成","年","月","日",null,null,"単記票データ","テキスト読","オンライン"]
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[25,"(7)受療の状況","04:糖尿病(性)眼合併症",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C31"]
[26,"(7)受療の状況","05:糖尿病(性)神経障害",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C32"]
[27,"(7)受療の状況","06:03～05以外の合併症を伴う糖尿病",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C33"]
[28,"(7)受療の状況","07:肥満(症) ",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C34"]
[29,"(7)受療の状況","08:脂質異常症(高コレステロール血症等)",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C35"]
[30,"(7)受療の状況","09:高血圧(症)",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C36"]
[31,"(7)受療の状況","10:虚血性心疾患",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C37"]
[32,"(7)受療の状況","11:脳卒中",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C38"]
[33,"(7)受療の状況","12:閉塞性末梢動脈疾患",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C39"]
[34,"(7)受療の状況","13:大動脈疾患(大動脈解離、大動脈瘤)",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C40"]
[35,"(7)受療の状況","14:慢性腎臓病(慢性腎不全等)",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C41"]
[36,"(7)受療の状況","15:精神疾患",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C42"]
[37,"(7)受療の状況","16:その他の疾患",null,"B28",null,null,"数字",1,1,1,null,null,null,null,"C43"]
[38,"(8)診療費等支払方法","自費診療",null,"B44",null,null,"数字",1,1,1,null,null,null,null,"C44"]
[39,"(8)診療費等支払方法","医療・公費",null,"B44",null,null,"数字",1,1,1,null,null,null,null,"C45"]
[40,"(8)診療費等支払方法","介護保険",null,"B44",null,null,"数字",1,1,1,null,null,null,null,"C46"]
[41,"(8)診療費等支払方法","Ⅰ医療保険等",null,"B47",null,null,"数字",1,1,7,null,null,null,null,"C47"]
[42,"(8)診療費等支払方法","Ⅱ公費負担医療","08感染症法","B48",null,null,"数字",1,1,1,null,null,null,null,"C48"]
[43,"(8)診療費等支払方法","Ⅱ公費負担医療","09障害者法","B48",null,null,"数字",1,1,1,null,null,null,null,"C49"]
[44,"(8)診療費等支払方法","Ⅱ公費負担医療","10生活保護法（医療扶助）","B48",null,null,"数字",1,1,1,null,null,null,null,"C50"]
[45,"(8)診療費等支払方法","Ⅱ公費負担医療","11その他の公費負担によるもの","B48",null,null,"数字",1,1,1,null,null,null,null,"C51"]
[46,"(9)病床の種別",null,null,"B52",null,"○","数字",1,1,2,null,null,null,null,"C52"]
[47,"(10)入院前の場所",null,null,"B53",null,"○","数字",2,1,12,null,null,null,null,"C53"]
[48,"(11)来院時の状況","通常・救急",null,"B54",null,"○","数字",1,1,3,null,null,null,null,"C54"]
[49,"(11)来院時の状況","診療時間",null,"B55",null,null,"数字",1,1,2,null,null,null,null,"C55"]
[50,"(12)手術の有無","有無",null,"B56",null,"○","数字",1,1,2,null,null,null,null,"C56"]
[51,"(12)手術の有無","元号",null,"B57",null,null,"数字",1,1,2,null,null,null,null,"C57"]
[52,"(12)手術の有無","年",null,"B57",null,null,"数字",2,1,31,null,null,null,null,"C58"]
[53,"(12)手術の有無","月",null,"B57",null,null,"数字",2,1,12,null,null,null,null,"C59"]
[54,"(12)手術の有無","日",null,"B57",null,null,"数字",2,1,31,null,null,null,null,"C60"]
[55,"(13)転帰",null,null,"B61",null,"○","数字",1,1,6,null,null,null,null,"C61"]
[56,"(14)退院後の行き先","所在地",null,"B62",null,null,"数字",2,1,12,null,null,null,null,"C62"]

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["フィールドID","記入のしかた（HTML）","項目名","表示範囲\n（先頭行）","表示範囲\n（後尾行）","単記票\n行位置","単記票\n列位置"]
[1,"●自動で採番されます。\n●入力不可です。\n","【患者番号】",8,null,7,2]
[2,"●性別を入力します。\n　　1又は2のいずれかを入力します。\n","【(1)性別】",8,null,8,2]
[3,"●出生年月日を入力します。\n　　「元号」は、1～5のいずれかを入力します。\n　　「年」「月」「日」は、数字を入力します。\n\n　　※生年月日が不明の場合は、「元号」「年」「月」「日」に9999を入力し、後ろ3桁に推定年齢を入力してください。\n　　　例）推定年齢が87歳の場合：「9999087」と入力。\n　　　（元号：9、年：99、月：9+年齢の百の位、日：年齢の後ろ2桁。）","【(2)出生年月日】",8,null,9,2]
[4,null,null,9,null,10,2]
[5,null,null,9,null,11,2]
[6,null,null,9,null,12,2]
[7,"●患者の住所を入力します。\n①　1又は2のいずれかを入力します。\n　1:当院と同じ都道府県内\n　2:当院とは別の都道府県\n②　①が「2:当院とは別の都道府県」の場合は、「都道府県」を漢字入力します。\n\n　　・外国人旅行者の場合は、①に「2」を入力し、②の「都道府県」に「外国」と入力してください。\n　　・住所不定又は不詳の場合は、①に「2」を入力し、②の「都道府県」に「不詳」と入力してください。\n","【(3)患者の住所】",8,null,13,2]
[8,null,null,9,null,14,2]
[9,"●過去の入院の有無を入力します。\n①　1又は2のいずれかを入力します。\n\n②　①が「1:有」の場合、退院年月日を入力します。\n　  「元号」は、1又は2のいずれかを入力します。\n　　「年」「月」「日」は数字を入力します。\n\n　・「過去の入院」とは、主傷病(※)に関連した貴院における入院であって、\n　 退院日が「(5)入院年月日」から遡って過去30日以内の場合に限ります。(退院年が令和及び平成の場合のみ。)\n　 (※)主傷病とは、「（7）受療の状況」の「(1)主傷病名」に記載する疾患をいいます。\n\n","【(4)過去の入院の有無】",8,null,15,2]
[10,null,null,9,null,16,2]
[11,null,null,9,null,17,2]
[12,null,null,9,null,18,2]
[13,null,null,9,null,19,2]
[14,"●入院年月日を入力します。\n　　「元号」は、1～3のいずれかを入力します。\n　　「年」「月」「日」は、数字を入力します。\n","【(5)入院年月日】",8,null,20,2]
[15,null,null,9,null,21,2]
[16,null,null,9,null,22,2]
[17,null,null,9,null,23,2]
[18,"●退院年月日を入力します。\n　　「日」は、数字を入力します。\n※令和8年9月中の退院日について入力します。\n","【(6)退院年月日】",8,null,24,2]
[19,"●受療の状況を入力します。\n　　1～5のいずれかを入力します。\n　　1:傷病の診断・治療\n　　2:正常分娩(単胎自然分娩)\n　　3:正常妊娠・産じょくの管理\n　　4:健康者に対する検査・健康診断(査)・管理\n　　5:その他の保健サービス\n","【(7)受療の状況】",8,null,25,2]
[20,"●主傷病名を入力します。\n　　受療の状況が「1:傷病の診断・治療」の場合は、「主傷病名」を漢字入力します。\n\n　 ※主傷病名については、以下の内容もできるだけ入力してください。\n　　　　発病の型(例：急性・慢性　等)\n　　　　病因(例：アルコール性　等)\n　　　　部位(例：胃噴門部　等)\n　　　　性状(例：悪性　等)\n　　　　重症度（例：ステージ４　等）\n　　例：アルコール性　急性膵炎\n　　　　慢性腎臓病、ステージ４\n　　　　胃噴門部の悪性新生物\n　　　　未分化大細胞型リンパ腫、ALK陰性\n　　　　後天性　溶血性　貧血",null,8,null,26,2]
[21,"●外傷の原因を入力します。\n　  主傷病名が外傷（中毒を含む）の場合は、1～9のいずれかを入力します。\n　不慮の事故\n　　　1:自動車交通事故\n　　　2:自転車交通事故\n　　　3:その他の交通事故\n　　　4:スポーツ中の事故\n　　　5:転倒・転落\n　　　6:1～5以外の原因による不慮の事故\n　故意又は不明\n　　　7:自傷\n　　　8:他傷\n　　　9:不明\n",null,8,null,27,2]
[22,"●副傷病名を入力します。\n　  主傷病名以外の傷病について、該当する項目すべてに「1」を入力します。\n　　　01:副傷病なし\n　　　02:糖尿病(合併症を伴わないもの)\n　　　03:糖尿病(性)腎症\n　　　04:糖尿病(性)眼合併症\n　　　05:糖尿病(性)神経障害\n　　　06:03～05以外の合併症を伴う糖尿病\n　　　07:肥満(症)\n　　　08:脂質異常症(高コレステロール血症等)\n　　　09:高血圧(症) \n　　　10:虚血性心疾患　\n　　　11:脳卒中\n　　　12:閉塞性末梢動脈疾患\n　　　13:大動脈疾患(大動脈解離、大動脈瘤)\n　　　14:慢性腎臓病(慢性腎不全等)\n　　　15:精神疾患\n　　　16:その他の疾患\n\n　 ※「15:精神疾患」とは、以下の疾患をいいます。\n　　　　　・アルツハイマー病を含む認知症\n　　　　　・精神作用物質による精神及び行動の障害\n　　　　　・統合失調症、統合失調症型障害及び妄想性障害\n　　　　　・気分［感情］障害\n　　　　　・神経症性障害\n　　　　　・てんかん\n　　　　　・その他の精神及び行動の障害\n　　　（ただし、知的障害＜精神遅滞＞は除きます。）\n",null,8,null,28,2]
[23,null,null,8,null,29,2]
[24,null,null,8,null,30,2]
[25,null,null,8,null,31,2]
[26,null,null,8,null,32,2]
[27,null,null,8,null,33,2]
[28,null,null,8,null,34,2]
[29,null,null,8,null,35,2]
[30,null,null,8,null,36,2]
[31,null,null,8,null,37,2]
[32,null,null,8,null,38,2]
[33,null,null,8,null,39,2]
[34,null,null,8,null,40,2]
[35,null,null,8,null,41,2]
[36,null,null,8,null,42,2]
[37,null,null,8,null,43,2]
[38,"●診療費等支払方法を入力します。\n①　該当する項目すべてに「1」を入力します。\n　　1:自費診療(保険外併用療養費を含む)\n　　2:医療保険等、公費負担医療\n　　3:介護保険(介護扶助を含む)\n\n②　①が「2:医療保険等、公費負担医療」の場合は、\n　　　　「Ⅰ 医療保険等」については該当する数字を1つ入力し、\n　　　　「Ⅱ 公費負担医療」については該当する項目すべてに「1」を入力します。\n\n　Ⅰ 医療保険等\n　　 01:健康保険・各種共済組合(本人)\n　　 02:健康保険・各種共済組合(家族)\n　　 03:国民健康保険\n　　 04:高齢者医療（後期高齢者医療制度）\n　　 05:労働災害・公務災害\n　　 06:自動車損害賠償保障法\n　　 07:その他\n\n　Ⅱ 公費負担医療\n　　08:感染症の予防及び感染症の患者に対する医療に関する法律\n　　09:障害者の日常生活及び社会生活を総合的に支援するための法律（育成医療、更生医療）\n　　10:生活保護法（医療扶助）\n　　11:その他の公費負担によるもの\n\n　　　※介護保険サービス利用者で、医療保険等と公費負担医療を併用している場合は、\n　　　   それらの両方について入力します。\n","【(8)診療費等支払方法】",8,null,44,2]
[39,null,null,8,null,45,2]
[40,null,null,null,null,46,2]
[41,null,null,8,null,47,2]
[42,null,null,8,null,48,2]
[43,null,null,8,null,49,2]
[44,null,null,8,null,50,2]
[45,null,null,8,null,51,2]
[46,"●病床の種別を入力します。\n　  1～2のいずれかを入力します。\n　1:療養病床\n　2:一般病床\n　","【(9)病床の種別】",8,null,52,2]
[47,"●入院前の場所を入力します\n　　1～12のいずれかを入力します。\n　家庭\n　　 1:当院に通院\n　　 2:他の病院・診療所に通院\n　　 3:在宅医療（訪問診療・訪問看護等）\n　　 4:その他\n　他の病院・診療所に入院\n　　 5:地域医療支援病院・特定機能病院\n　　 6:その他の病院\n　　 7:診療所\n　その他\n　　 8:介護医療院に入所\n　　 9:介護老人保健施設に入所\n　　10:介護老人福祉施設に入所\n　　11:社会福祉施設に入所\n　　12:その他（新生児・不明等）\n","【(10)入院前の場所】",8,null,53,2]
[48,"●来院時の状況を入力します。\n①　1～3のいずれかを入力します。\n  　1:通常の受診\n　救急の受診\n　  2:救急車により搬送\n　  3:徒歩や自家用車等による救急の受診\n\n②　①が「2:救急車により搬送」又は「3:徒歩や自家用車等による救急の受診」（救急の受診）の場合は、\n　　1又は2のいずれかを入力します。\n　1:診療時間内の受診\n　2:診療時間外の受診","【(11)来院時の状況】",8,null,54,2]
[49,null,null,8,null,55,2]
[50,"●手術の有無を入力します。\n①1又は2のいずれかを入力します。\n\n②　①が「1:有」の場合は、手術日を入力します。\n　  「元号」は、1又は2のいずれかを入力します。\n　　「年」「月」「日」は、数字を入力します。\n　　※元号が令和又は平成の手術日について入力します。","【(12)手術の有無】",8,null,56,2]
[51,null,null,9,null,57,2]
[52,null,null,9,null,58,2]
[53,null,null,9,null,59,2]
[54,null,null,9,null,60,2]
[55,"●転帰を入力します。\n　1～6のいずれかを入力します。\n　1:治癒\n　2:軽快\n　3:不変\n　4:悪化\n　5:死亡\n　6:その他\n","【(13)転帰】",8,null,61,2]
[56,"●退院後の行き先を入力します。\n\n(13)転帰で「5:死亡」の場合は入力の必要はありません。\n\n　　1～12のいずれかを入力します。\n　家庭\n　　 1:当院に通院\n　　 2:他の病院・診療所に通院\n　　 3:在宅医療（訪問診療・訪問看護等）\n　　 4:その他\n　他の病院・診療所に入院\n　　 5:地域医療支援病院・特定機能病院\n　　 6:その他の病院\n　　 7:診療所\n　その他\n　　 8:介護医療院に入所\n　　 9:介護老人保健施設に入所\n　　10:介護老人福祉施設に入所\n　　11:社会福祉施設に入所\n　　12:その他（不明等）\n","【(14)退院後の行き先】",8,null,62,2]

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["都道府県コード","都道府県名","政令指定都市フラグ","調査票コード","調査票名",null,"市群コード","市群名称","区町村コード","区町村名",null,"元号","元号MAX年",null,"プレプリント項目","プレプリント値",null,"XML出力項目","タグ名",null,null,null,null,null,null,"調査票名",null,null,null,null,"調査日","調査日",null,"調査票チェックフラグ"]
["01","北海道",1,"4","一般診療所票（入院）",null,null,null,null,null,null,"1 令和",5,null,"対象者認証情報格納エリア",null,null,"対象者認証情報格納エリア","taishosha_cer",null,null,null,null,null,null,"調査票種別",null,null,null,null,1,"１日",null,"調査票名","フラグ"]
["02","青森県",null,"5","一般診療所票（外来）",null,null,null,null,null,null,"2 平成",31,null,"認証統計調査コード",null,null,"認証統計調査コード","cer_toke_cd",null,null,null,null,null,null,"都道府県",null,null,null,null,2,"２日",null,"一般診療所票（入院）","0"]
["03","岩手県",null,"8","一般診療所退院票",null,null,null,null,null,null,"3 昭和",64,null,"認証調査対象者ID",null,null,"認証調査対象者ID","cer_taishosha_id",null,null,null,null,null,null,"都道府県CD",null,null,null,null,3,"３日",null,"一般診療所票（外来）","0"]
["04","宮城県",1,null,null,null,null,null,null,null,null,"4 大正",15,null,"確認コード",null,null,"確認コード","cer_kakunin_cd",null,null,null,null,null,null,"施設番号",null,null,null,null,4,"４日",null,"一般診療所退院票","0"]
["05","秋田県",null,null,null,null,null,null,null,null,null,"5 明治",45,null,"36進統計調査コード",null,null,"36進統計調査コード","toke_cd_36",null,null,null,null,null,null,"チェックOK日時","0",null,null,null,5,"５日"]
["06","山形県",null,null,null,null,null,null,null,null,null,"9 不詳",99,null,"送信先URL1",null,null,"送信先URL1","soshin1",null,null,null,null,null,null,"施設名",null,null,null,null,6,"６日"]
["07","福島県",null,null,null,null,null,null,null,null,null,null,null,null,"送信先URL2",null,null,"送信先URL2","soshin2",null,null,null,null,null,null,"調査日",null,null,null,null,7,"７日"]
["08","茨城県",null,null,null,null,null,null,null,null,null,null,null,null,"管理情報格納エリア",null,null,"管理情報格納エリア","kanri",null,null,null,null,null,null,"調査年月日",null,null,null,null,8,"８日"]
["09","栃木県",null,null,null,null,null,null,null,null,null,null,null,null,"統計調査コード",null,null,"統計調査コード","toke_cd",null,null,null,null,null,null,"初期フラグ",null,null,null,null,9,"９日"]
["10","群馬県",null,null,null,null,null,null,null,null,null,null,null,null,"実施時期コード",null,null,"実施時期コード","jiki_cd",null,null,null,null,null,null,null,null,null,null,null,10,"１０日"]
["11","埼玉県",1,null,null,null,null,null,null,null,null,null,null,null,"調査対象者ID",null,null,"調査対象者ID","taishosha_id",null,null,null,null,null,null,null,null,null,null,null,11,"１１日"]
["12","千葉県",1,null,null,null,null,null,null,null,null,null,null,null,"電子調査票ID",null,null,"電子調査票ID","chosahyo_id",null,null,null,null,null,null,null,null,null,null,null,12,"１２日"]
["13","東京都",1,null,null,null,null,null,null,null,null,null,null,null,"キー項目",null,null,"キー項目","key_komoku",null,null,null,null,null,null,null,null,null,null,null,13,"１３日"]
["14","神奈川県",null,null,null,null,null,null,null,null,null,null,null,null,"連絡先情報格納エリア",null,null,"連絡先情報格納エリア","renraku",null,null,null,null,null,null,null,null,null,null,null,14,"１４日"]
["15","新潟県",1,null,null,null,null,null,null,null,null,null,null,null,"メールアドレス",null,null,"メールアドレス","mail_adr",null,null,null,null,null,null,null,null,null,null,null,15,"１５日"]
["16","富山県",null,null,null,null,null,null,null,null,null,null,null,null,"氏名",null,null,"氏名","shime",null,null,null,null,null,null,null,null,null,null,null,16,"１６日"]
["17","石川県",null,null,null,null,null,null,null,null,null,null,null,null,"会社名",null,null,"会社名","kaisha",null,null,null,null,null,null,null,null,null,null,null,17,"１７日"]
["18","福井県",null,null,null,null,null,null,null,null,null,null,null,null,"英文会社名",null,null,"英文会社名","kaisha_e",null,null,null,null,null,null,null,null,null,null,null,18,"１８日"]
["19","山梨県",null,null,null,null,null,null,null,null,null,null,null,null,"商号",null,null,"商号","shogo",null,null,null,null,null,null,null,null,null,null,null,20,"２０日"]
["20","長野県",null,null,null,null,null,null,null,null,null,null,null,null,"支店名",null,null,"支店名","shiten",null,null,null,null,null,null,null,null,null,null,null,20,"２０日"]
["21","岐阜県",null,null,null,null,null,null,null,null,null,null,null,null,"店舗名",null,null,"店舗名","tempo",null,null,null,null,null,null,null,null,null,null,null,21,"２１日"]
["22","静岡県",1,null,null,null,null,null,null,null,null,null,null,null,"代表者名",null,null,"代表者名","daihyosha",null,null,null,null,null,null,null,null,null,null,null,23,"２３日"]
["23","愛知県",1,null,null,null,null,null,null,null,null,null,null,null,"法人名",null,null,"法人名","hojin",null,null,null,null,null,null,null,null,null,null,null,22,"２２日"]
["24","三重県",null,null,null,null,null,null,null,null,null,null,null,null,"学校名",null,null,"学校名","gakko",null,null,null,null,null,null,null,null,null,null,null,24,"２４日"]
["25","滋賀県",null,null,null,null,null,null,null,null,null,null,null,null,"部署名",null,null,"部署名","busho",null,null,null,null,null,null,null,null,null,null,null,25,"２５日"]
["26","京都府",1,null,null,null,null,null,null,null,null,null,null,null,"担当者名",null,null,"担当者名","tantosha",null,null,null,null,null,null,null,null,null,null,null,26,"２６日"]
["27","大阪府",1,null,null,null,null,null,null,null,null,null,null,null,"住所",null,null,"住所","jusho",null,null,null,null,null,null,null,null,null,null,null,27,"２７日"]
["28","兵庫県",1,null,null,null,null,null,null,null,null,null,null,null,"所在地",null,null,"所在地","shozaichi",null,null,null,null,null,null,null,null,null,null,null,28,"２８日"]
["29","奈良県",null,null,null,null,null,null,null,null,null,null,null,null,"本社・本店所在地",null,null,"本社・本店所在地","shozaichi_2",null,null,null,null,null,null,null,null,null,null,null,29,"２９日"]
["30","和歌山県",null,null,null,null,null,null,null,null,null,null,null,null,"ビル名",null,null,"ビル名","biru",null,null,null,null,null,null,null,null,null,null,null,30,"３０日"]
["31","鳥取県",null,null,null,null,null,null,null,null,null,null,null,null,"郵便番号",null,null,"郵便番号","yubin_no",null,null,null,null,null,null,null,null,null,null,null,31,"３１日"]
["32","島根県",null,null,null,null,null,null,null,null,null,null,null,null,"本社・本店郵便番号",null,null,"本社・本店郵便番号","yubin_no_2"]
["33","岡山県",1,null,null,null,null,null,null,null,null,null,null,null,"電話番号",null,null,"電話番号","tel_no"]
["34","広島県",1,null,null,null,null,null,null,null,null,null,null,null,"本社・本店電話番号",null,null,"本社・本店電話番号","tel_no_2"]
["35","山口県",null,null,null,null,null,null,null,null,null,null,null,null,"内線番号",null,null,"内線番号","naisen_no"]
["36","徳島県",null,null,null,null,null,null,null,null,null,null,null,null,"携帯電話番号",null,null,"携帯電話番号","ketai_no"]
["37","香川県",null,null,null,null,null,null,null,null,null,null,null,null,"ＦＡＸ番号",null,null,"ＦＡＸ番号","fax_no"]
["38","愛媛県",null,null,null,null,null,null,null,null,null,null,null,null,"備考１",null,null,"備考１","biko_1"]
["39","高知県",null,null,null,null,null,null,null,null,null,null,null,null,"備考２",null,null,"備考２","biko_2"]
["40","福岡県",1,null,null,null,null,null,null,null,null,null,null,null,"備考３",null,null,"備考３","biko_3"]
["41","佐賀県",null,null,null,null,null,null,null,null,null,null,null,null,"-",null,null,"調査票回答格納エリア","kaito"]
["42","長崎県",null,null,null,null,null,null,null,null,null,null,null,null,"都道府県",null,null,"入院1～50","nyuin"]
["43","熊本県",1,null,null,null,null,null,null,null,null,null,null,null,"施設番号",null,null,"外来1～1500","gairai"]
["44","大分県",null,null,null,null,null,null,null,null,null,null,null,null,"施設名",null,null,"退院1～300","taiin"]
["45","宮崎県",null,null,null,null,null,null,null,null,null,null,null,null,"調査日"]
["46","鹿児島県",null,null,null,null,null,null,null,null,null,null,null,null,"一般診療所票（入院）"]
["47","沖縄県",null,null,null,null,null,null,null,null,null,null,null,null,"一般診療所票（外来）"]
[48,"不詳",null,null,null,null,null,null,null,null,null,null,null,null,"一般診療所退院票"]
[49,"外国"]