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{"sheet":"診断書","index":0,"n_rows":36,"n_cols":20,"rows_kept":36,"cut":false,"hidden":false,"merged":[[0,1,1,6],[0,8,0,15],[1,8,2,10],[1,11,2,15],[2,2,3,6],[4,1,4,6],[33,1,34,2],[8,5,8,15],[9,1,9,4],[9,5,9,15],[21,6,21,15],[22,1,27,2],[28,1,32,2],[8,1,8,4],[34,5,34,14],[32,4,32,14],[10,10,10,14],[4,10,4,15],[5,10,5,15],[6,10,6,15],[7,10,7,15],[27,4,27,14],[6,1,6,5],[18,4,18,6],[18,8,18,10],[18,11,18,12],[20,4,20,6],[20,8,20,10],[20,11,20,12],[11,2,11,15],[13,2,15,15],[17,4,17,6],[17,8,17,10],[17,11,17,12]]}
[null,"診断書"]
[]
[]
[]
[null,"文京区長殿　文京区教育委員会 殿",null,null,null,null,null,null,"医療機関"]
[null,null,"下記の通り診断します。",null,null,null,null,null,"所在地"]
[null,null,null,null,null,null,"発行",null,"電話番号"]
[null,null,null,null,null,null,null,null,"担当医師"]
[null,"受診者（患者）の氏名"]
[null,"受診者（患者）の住所"]
[null,"【傷病名】",null,null,null,null,null,null,"【初診年月日】　　　　　　　　年　　　　月　　　　日"]
[]
[null,"【経過状況および所見（仕事・家事・育児の制限を含め）】"]
[]
[]
[]
[null,"【入院・通院・療養・静養】"]
[null,null,"入院",null,null,null,null,"～",null,null,null,"予定"]
[null,null,"通院",null,null,null,null,"～",null,null,null,"予定"]
[null,null,"通院頻度",null,"週","月",null,"日",null,"不定期",null,null,null,null,null,null,false,false,false,{"$f":"IF(COUNTIF(Q20:S20,TRUE)>0,2,1)","v":1}]
[null,null,"療養・静養",null,null,null,null,"～",null,null,null,"予定"]
[null,"【医学的見地からの現在の状態】",null,null,null,null,"※該当の選択肢に☑し、育児・生活において特記すべきことがあればご記入ください。"]
[null,"日常生活",null,"　　 ①日常生活に問題ない",null,null,null,null,null,null,null,null,null,null,null,null,false,{"$f":"IF(COUNTIF(Q23:Q27,TRUE)=1,2,1)","v":1}]
[null,null,null,"　　 ②基本的に日常生活はできるが、一部介助・支援が必要である。",null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,null,null,"　　 ③基本的に日常生活はできるが、療養が必要である。",null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,null,null,"　　 ④日常生活に支障があり、多くの介助・支援が必要である。",null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,null,null,"　　 ⑤常時、臥床、また安静を保つ必要がある。",null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,null,null,"特記（　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　）",null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,"小学校就学前の\n子どもの育児",null,"　　 ①特段の制限はなく、育児を行うことは可能である。…（「保育の必要性」の事由に該当しない）",null,null,null,null,null,null,null,null,null,null,null,null,false,{"$f":"IF(COUNTIF(Q29:Q32,TRUE)=1,2,1)","v":1}]
[null,null,null,"　　 ②概ね育児は可能だが、症状の安定・改善のためには一部育児の援助が望まれる。",null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,null,null,"　　 ③育児が難しい場合が多く、症状の安定・改善のためには継続的な育児の援助が望まれる。",null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,null,null,"　　 ④育児をすることは非常に難しい状態であり、早急に育児の援助が必要である。",null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,null,null,"特記（　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　）",null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,"保育園\nの送迎",null,"　　非常に困難",null,null,"毎日は困難",null,null,"ほぼ支障なし",null,null,null,null,null,null,false,false,false,false]
[null,null,null,"　　その他（",null,null,null,null,null,null,null,null,null,null,null,"）",{"$f":"IF(COUNTIF(Q34:T34,TRUE)=1,2,1)","v":1},{"$f":"IF(AND(T34=TRUE,F35=\"\"),1,2)","v":2}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"文京区 幼児保育課 入園相談係　電話 03-5803-1190"]