{"text_format":"1","workbook":"xlsx","n_sheets":14,"sheets":["Sheet1","Message","Kojin","Kojin3","Kojin2","Jigyo","Set","申請総括票","申請書","取下申請総括票","取下申請書","申請書一覧","請求書","請求一覧"],"not_rendered":{"charts":0,"images":3,"macros":1,"external_links":0,"defined_names":13,"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":"Sheet1","index":0,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":true,"merged":[]}

{"sheet":"Message","index":1,"n_rows":25,"n_cols":2,"rows_kept":25,"cut":false,"hidden":false,"merged":[[6,1,6,3],[1,1,1,6],[2,1,2,6],[5,1,5,3],[24,1,24,5]]}
[]
[null," マクロセキュリティ レベルが｢高｣に設定されているか、[マクロを無効にする]が選択されたため、システムを起動できません。"]
[null,"セキュリティレベルを｢中｣に変更するか、[マクロを有効にする]を選択したください。"]
[]
[]
[]
[]
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[null," Ｅｘｃｅｌ２０１０以降をご使用されている方は、上記の「コンテンツの有効化」をクリックしてください。"]

{"sheet":"Kojin","index":2,"n_rows":1,"n_cols":21,"rows_kept":1,"cut":false,"hidden":true,"merged":[]}
["被保険者番号","被保険者氏名","補記","フリガナ","性","生年月日","区コード","区名","住所","電話番号","要介護度","利用開始日","利用終了日","月","火","水","木","金","土","日","他"]

{"sheet":"Kojin3","index":3,"n_rows":1,"n_cols":21,"rows_kept":1,"cut":false,"hidden":true,"merged":[]}
["被保険者番号","被保険者氏名","補記","フリガナ","性","生年月日","区コード","区名","住所","電話番号","要介護度","利用開始日","利用終了日","月","火","水","木","金","土","日","他"]

{"sheet":"Kojin2","index":4,"n_rows":1,"n_cols":22,"rows_kept":1,"cut":false,"hidden":true,"merged":[]}
["利用者番号","利用者氏名","補記","フリガナ","性","生年月日","区コード","区名","住所","電話番号","週回数","利用開始日","利用終了日","月","火","水","木","金","土","日","他","昼夕"]

{"sheet":"Jigyo","index":5,"n_rows":1,"n_cols":5,"rows_kept":1,"cut":false,"hidden":true,"merged":[]}
["事業者番号","事業者名","所在地","氏名","電話番号"]

{"sheet":"Set","index":6,"n_rows":18,"n_cols":10,"rows_kept":18,"cut":false,"hidden":true,"merged":[]}
["申請区分","要介護区分","給付割合","実績年月","特別給付額","区","保険者番号","元号","バージョン情報","助成額"]
["0,支給申請","要介護1",90,13,200,"00,すべて",231001,"明治","9.00",90]
["1,取下申請","要介護2",80,null,null,"01,千種",231019,"大正",null,180]
[null,"要介護3",70,null,null,"02,東",231027,"昭和",null,200]
[null,"要介護4",100,null,null,"03,北",231035,"平成"]
[null,"要介護5",95,null,null,"04,西",231043]
[null,"要支援",93,null,null,"05,中村",231050]
[null,"事業対象者",86,null,null,"06,中",231068]
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[null,null,79,null,null,"08,瑞穂",231084]
[null,null,null,null,null,"09,熱田",231092]
[null,null,null,null,null,"10,中川",231100]
[null,null,null,null,null,"11,港",231118]
[null,null,null,null,null,"12,南",231126]
[null,null,null,null,null,"13,守山",231134]
[null,null,null,null,null,"14,緑",231142]
[null,null,null,null,null,"15,名東",231159]
[null,null,null,null,null,"16,天白",231167]

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["※クリップ類で束ねてください。"]
[" （ホッチキス留めは受付けません）"]
[]
[]
[]
["配食サービス提供証明書兼配食サービス費支給申請総括票"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"平成",null,null,null,null,null,"年",null,null,null,null,"月",null,null,null,null,"日"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,15,null,null,null,null,17,null,null,null,null,19]
[null,"名　古　屋　市　長",null,null,null,null,null,null,null,null,null,"様"]
[]
[]
[null,"（",null,null,null,null,null,null,null,null,"区分）"]
[]
[null,"保険者番号"]
[null,2,null,3]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所名"]
[]
[null,21,null,null,null,null,null,null,null,null,null,null,26,null,null,null,"事業者番号"]
[null,"※","保険者番号は区ごとに番号が異なるため"]
[null,null,"必ず確認して下さい。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,27,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,36]
[]
[]
[null,null,null,null,null,"配食サービス区分"]
[]
[null,null,null,null,null,null,"１．生活援助型"]
[null,"名古屋市",null,null,null,null,"　  　(要介護１～5）",null,null,null,null,null,null,null,null,null," 配食サービス費について、次のとおり支給申請します。"]
[]
[null,null,null,null,null,null,"２．自立支援型"]
[null,null,null,null,null,null,"　 (要支援1～2、事業対象者）"]
[null,null,null,null,null,null,41]
[null,"※","提供月が平成３０年３月以前の場合、要支援認定者は生活援助型の配食サービス区分で申請して下さい。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,"平成",null,null,null,null,null,"年",null,null,null,null,null,"月分"]
[null,null,null,null,null,null,null,null,37,null,null,null,null,null,39]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[]
[]
[null,null,null,null,null,null,null,null,null,"ただし、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 始め、",null,null,null,null,null,null,null,null,"件"]
[null,null,null,null,null,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,null,null,null,null,44]
[]
[null,null,null,"チェック欄"]
[null,null,null,null,"利用開始申請書の提出をした上で、支給申請をしている。また、配食サービス区分が変更になった場合は、新たな配食サービス区分で利用開始申請書を提出している。"]
[]
[null,null,null,null,"認定・事業対象者の有効期間を介護保険被保険者証で確認している。"]
[]
[null,null,null,null,"利用者の負担割合を介護保険負担割合証で確認している。"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(平成３０年５月　改訂版）"]

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[]
[null,"（第３号様式）"]
[]
[]
[]
["配食サービス提供証明書兼配食サービス費支給申請書"]
[]
[]
[null,"提供事業所名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(令和３年４月　改訂版）"]
[null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"配食サービス区分"]
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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," 1 :生活援助型（要介護）"]
[null,"フリガナ"]
[null,"被保険者氏名",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 :自立支援型(要支援,事業対象者)"]
[]
[null,"配食サービス\n実績",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付率※"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※７０～１００の数字をご記入下さい。\n（例）１割負担は０９０、２割負担は０８０"]
[null,null,null,null,null,null," 平成",null,null,null,null,null,"年",null,null,null,null,null,"月分"]
[]
[null,null,null,null,null,null,null,null,54,null,null,null,null,null,56]
[null,null,null,null,null,null,null,null,1,null,null,2,null,null,3,null,null,4,null,null,5,null,null,6,null,null,7,null,null,null,null,8,null,null,null,9,null,null,null,10]
[]
[]
[]
[null,null,null,null,null,null,null,null,61]
[null,null,null,null,null,null,null,null,11,null,null,12,null,null,13,null,null,14,null,null,15,null,null,16,null,null,17,null,null,null,null,18,null,null,null,19,null,null,null,20]
[]
[]
[]
[null,null,null,null,null,null,null,null,71]
[null,null,null,null,null,null,null,null,21,null,null,22,null,null,23,null,null,24,null,null,25,null,null,26,null,null,27,null,null,null,null,28,null,null,null,29,null,null,null,30]
[]
[]
[]
[null,null,null,null,null,null,null,null,81]
[null,null,null,null,null,null,null,null,31]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"  計",null,null,null,null,null,null,null,"日"]
[null,null,null,null,null,null,null,null,91,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,92]
[null,null,null,null,null,null,null,null,"※配食を利用した日に、｢１｣を記入してください。"]
[]
[]
[null,"上記のとおり、配食サービスを受けたことを証明します。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null," 年",null,null," 月",null,null,null,null," 日"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（利用者）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ","住    所"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏    名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
[]
[null,"支給申請欄（事業者使用欄）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電話番号"]
[]
[]
[]
[null,null,"上記利用者にかかる、平成",null,null,null,null,null,null,null,null,null,"年",null,null,"月分 　配食サービス費について、以下のとおり支給申請します。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"平成",null,null,null,null,null," 年",null,null," 月",null,null,null,null," 日"]
[]
[null,null,null,"名古屋市長　様"]
[null,null,null,null,null,null,null,null,null,null,null," 申請者",null,null,null,null,"事業者名"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"所 在 地"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏    名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電話番号"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null," 支給申請額",null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,94,"▲",null,null,null,null,null,97]
[]
[null,null,null,null,null,null,null,null,null,null,null,"（＠",null,null,"× 給付率",null,null,null,null,null,"％ × 提供日数",null,null,null,null,null,null," 日 ＝ ",null,null,null,null,null,null,null,null,null,null,null,null,"円）"]

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["※クリップ類で束ねてください。"]
[" （ホッチキス留めは受付けません）"]
[]
[]
[]
["配食サービス費支給取下申請総括票"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"平成",null,null,null,null,null,"年",null,null,null,null,"月",null,null,null,null,"日"]
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[null,"名　古　屋　市　長",null,null,null,null,null,null,null,null,null,"様"]
[]
[]
[null,"（",null,null,null,null,null,null,null,null,"区分）"]
[]
[null,"保険者番号"]
[null,2,null,3]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所名"]
[]
[null,21,null,null,null,null,null,null,null,null,null,null,26,null,null,null,"事業者番号"]
[null,"※","保険者番号は区ごとに番号が異なるため"]
[null,null,"必ず確認して下さい。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,27,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,36]
[]
[]
[null,null,null,null,"配食サービス区分"]
[]
[null,null,null,null,null,"１．生活援助型"]
["名古屋市",null,null,null,null,"　  　(要介護１～5）",null,null,null,null,null,null,null,null,null," 配食サービス費について、次のとおり支給取下申請します。"]
[]
[null,null,null,null,null,"２．自立支援型"]
[null,null,null,null,null,"　 (要支援1～2、事業対象者）"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,"平成",null,null,null,null,null,"年",null,null,null,null,null,"月分"]
[null,null,null,null,null,null,null,null,37,null,null,null,null,null,39]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[]
[]
[null,null,null,null,null,null,null,null,null,"ただし、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 始め、",null,null,null,null,null,null,null,null,"件"]
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[]
[]
[]
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[]
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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,"(平成３０年５月　改訂版）"]

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[]
[]
[]
[]
[]
["配食サービス費支給取下申請書"]
[]
[]
[null,"提供事業所名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(令和３年４月　改訂版）"]
[null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"配食サービス区分"]
[]
[null,null,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 :生活援助型（要介護）"]
[null,"フリガナ"]
[null,"被保険者氏名",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 :自立支援型(要支援,事業対象者)"]
[]
[null,"配食サービス\n実績",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付率※"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※７０～１００の数字をご記入下さい。\n（例）１割負担は０９０、２割負担は０８０"]
[null,null,null,null,null,null," 平成",null,null,null,null,null,"年",null,null,null,null,null,"月分"]
[]
[null,null,null,null,null,null,null,null,54,null,null,null,null,null,56]
[null,null,null,null,null,null,null,null,1,null,null,2,null,null,3,null,null,4,null,null,5,null,null,6,null,null,7,null,null,null,null,8,null,null,null,9,null,null,null,10]
[]
[]
[]
[null,null,null,null,null,null,null,null,61]
[null,null,null,null,null,null,null,null,11,null,null,12,null,null,13,null,null,14,null,null,15,null,null,16,null,null,17,null,null,null,null,18,null,null,null,19,null,null,null,20]
[]
[]
[]
[null,null,null,null,null,null,null,null,71]
[null,null,null,null,null,null,null,null,21,null,null,22,null,null,23,null,null,24,null,null,25,null,null,26,null,null,27,null,null,null,null,28,null,null,null,29,null,null,null,30]
[]
[]
[]
[null,null,null,null,null,null,null,null,81]
[null,null,null,null,null,null,null,null,31]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"  計",null,null,null,null,null,null,null,"日"]
[null,null,null,null,null,null,null,null,91,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,92]
[null,null,null,null,null,null,null,null,"※支給取り下げを行なう日に、｢１｣を記入してください。"]
[]
[]
[]
[]
[null,"申 請 欄"]
[]
[]
[]
[null,null,"上記利用者にかかる、平成",null,null,null,null,null,null,null,null,null,"年",null,null,"月分 　配食サービス費について、以下のとおり支給取下を申請します。"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"平成",null,null,null,null,null," 年",null,null," 月",null,null,null,null," 日"]
[]
[]
[null,null,null,"名古屋市長　様"]
[null,null,null,null,null,null,null,null,null,null,null," 申請者",null,null,null,null,"事業所名"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"所 在 地"]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏    名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電話番号"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null," 支給取下申請額",null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,94,"▲",null,null,null,null,null,97]
[]
[null,null,null,null,null,null,null,null,null,null,null,"（＠",null,null,"× 給付率",null,null,null,null,null,"％ × 提供日数",null,null,null,null,null,null," 日 ＝ ",null,null,null,null,null,null,null,null,null,null,null,null,"円）"]

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[]
[]
[null,"配食サービス費支給申請書印刷一覧"]
[]
[null,null,"提供年月：",null,null,null,null,null,"申請年月日："]
[]
[null,null,"件数",null,"申請金額"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"総合計",{"$f":"SUM(C8:D22)","v":0},null,{"$f":"SUM(E8:E23)","v":0}]
[]
[null,"項番","区名","被保険者番号",null,"被保険者氏名",null,null,"申請額",null,"給付割合","提供日数","補記"]

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[]
[null,"（第７号様式）"]
[]
["自立支援配食サービス事業"]
["　サービス提供明細書兼請求書"]
["（あて先）",null,null,null,"名古屋市長"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"平成",null,null,null,null,null,null,null,"年",null,null,null,null,"月",null,null,null,null,"日"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"所在地"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業者名"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電話番号"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業者番号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　",null," "]
[null,null,null,"平成　　　　",null,null,null,"年",null,null,"月分の自立支援配食サービスについて、下記のとおり請求します。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"金　",null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"内訳",null,"＠",null,null,null,"円",null,"×",null,null,null,null,null,"日　(食)"]
[]
[null,"利用者番号"]
[]
[]
[null,"フリガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１食あたりの請求額"]
[null,"利用者名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"＠９０　　・　　＠１８０　　・　　＠２００"]
[]
[]
[null,"配食実績"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（申出内容）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"月・火・水・木・金・土・日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"昼　・　夕"]
[null,null,null,null,null,null," 平成",null,null,null,null,null,"年",null,null,null,null,null,"月分"]
[]
[]
[null,null,null,null,null,null,null,null,1,null,null,2,null,null,3,null,null,4,null,null,5,null,null,6,null,null,null,7,null,null,null,null,null,8,null,null,null,null,9,null,null,null,null,null,10]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,11,null,null,12,null,null,13,null,null,14,null,null,15,null,null,16,null,null,null,17,null,null,null,null,null,18,null,null,null,null,19,null,null,null,null,null,20]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,21,null,null,22,null,null,23,null,null,24,null,null,25,null,null,26,null,null,null,27,null,null,null,null,null,28,null,null,null,null,29,null,null,null,null,null,30]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,31]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[]
[]
[]
[]
[]
[null,null,null,null,"上記のとおり、配食サービスの提供を受けたことを確認いたしました。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,null,"年",null,null,null,null,"月",null,null,null,null,"日"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ","住    所"]
[null,null,null,null,null,"合計"]
[null,null,null,null,null,null,null,null,null,null,null,"日"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏    名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(令和３年４月　改訂版）"]

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[]
[]
[null,"配食サービス費請求書印刷一覧"]
[]
[null,null,"提供年月：",null,null,null,null,null,"申請年月日："]
[]
[null,null,"合計件数"]
[null,null,"合計金額"]
[]
[null,"項番","区名","利用者番号",null,"利用者氏名",null,null,"請求額",null,"助成額","提供日数","補記"]