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[{"$nulls":6},"【様式第３号】"]
[]
[{"$nulls":5},"保険医療機関等番号"]
[]
[]
[{"$nulls":5},"令和　　   　　年　　　月　　日　"]
[]
[]
[null,"佐 賀 県 知 事　様",null,null,"委託保険医療機関等の所在地及び名称"]
[]
[]
[{"$nulls":4},"開設者氏名"]
[{"$nulls":4},"連絡先"]
[]
["佐賀県風しん抗体検査事業　実施報告書（令和　　　年　　　月分）"]
[]
[null,"委託契約に基づき、風しん抗体検査を次のとおり実施したので、問診票を添えて報告いたします。"]
[]
[null,"風しん抗体検査","抗体検査の種類",null,"委託料単価(円※）","件　数","金　額（円※）"]
[null,null,1,"HI法",null,null,0]
[null,null,2,"EIA法",null,null,0]
[{"$nulls":5},"※税込み価格を記載。\n　単価は実施年度の単価を記載。"]