{"text_format":"1","workbook":"xlsx","n_sheets":1,"sheets":["Sheet1"],"not_rendered":{"charts":0,"images":0,"macros":1,"external_links":0,"defined_names":1,"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":56,"n_cols":31,"rows_kept":56,"cut":false,"hidden":false,"merged":[[0,23,0,29],[2,0,2,29],[3,0,3,30],[11,4,11,6],[11,8,11,9],[11,11,11,12],[9,4,9,13],[10,4,10,13]]}
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"報告日:",null,null,{"$f":"TODAY()","v":"2025-12-10"}]
[]
["【服薬情報提供書（兼 心不全フォローアップシート）】"]
["<注意>このFAXによる情報伝達は、疑義照会ではありません。疑義照会は通常通り電話連絡にてお願いします"]
[]
["担当医　　",null,null,null,"循環器内科",null,null,null,null,null,null,null,null,null,null,"施設名・所在地"]
[]
[null,null,null,null,null,null,null,null,null,null,"先生　御机下"]
[]
["当院患者ID :"]
["患者氏名 :",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"TEL :",null,null,null,null,null,null,"FAX :"]
["生年月日 : ",null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,"担当薬剤師 :"]
[]
["この情報を伝える上で、患者からの同意を",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（代諾者続柄: ",null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[]
[]
["　該当する項目に、印☑を付けて、FAXにてご連絡ください"]
[]
["＜確認方法＞",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,"）"]
[]
["＜療養上の問題点＞"]
[null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[]
[]
["＜確認項目＞"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(",null,null,null,null,")"]
[]
[null,null,null,null,"　飲み忘れやすい薬剤・服用時点　（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,"　服薬管理",null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,"※コンプライアンス不良の場合は、服薬の重要性と飲み忘れ時の対処法について指導をお願いします"]
[null,"　提案事項等については備考欄に記載してください"]
[]
[null,null,null,null,null,null,"："]
["　  "]
[]
[]
[]
[null,null,null,null,"衛生を　",null,null,null,null,null,null,null,null,null,null,"⇐　いずれかにチェックをしてください"]
[null,null,null,null,null,"緩下剤や整腸剤の処方",null,null,null,null,null,null,null,null,null,null,null,"⇐　いずれかにチェックをしてください"]
[]
["＜受診勧奨＞"]
["①","下記の症状に該当したため、患者さんに対し、すみやかに当院へ連絡の上、受診を促したことを報告します"]
[]
[]
["②","下記の症状に該当したため、患者さんに対し、直近の主治医外来への受診予約日変更を勧めたことを報告します"]
[]
[]
["備考（必要に応じて記載してください。）"]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2025年12月　第1版"]