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[null,"健康保険　登録情報変更（訂正）届"]
[]
[]
[]
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[null,"届出年月日",null,null,null,"令和",null,null,null,"年",null,null,"月",null,null,"日","届出理由"]
[{"$nulls":28},"（",{"$nulls":8},"）"]
[null,"記号・番号\n（保険証左上に記載）",{"$nulls":10},"－",{"$nulls":6},"事業所名"]
[]
[null,"被保険者氏名",{"$nulls":21},"被保険者\nTEL",null,null,"　　　　　　　（　　　　　　　　　　）"]
[]
[]
[null,"■以下の変更の方は、健康保険証の交換が必要となります。"]
[null,null,"　氏名  ",null,"対象者",{"$nulls":6},"変更（訂正）前氏名",{"$nulls":14},"変更（訂正）後氏名"]
[{"$nulls":11},"ﾌﾘｶﾞﾅ",{"$nulls":14},"ﾌﾘｶﾞﾅ"]
[]
[]
[{"$nulls":8},"続柄",null,null,"ﾌﾘｶﾞﾅ",{"$nulls":14},"ﾌﾘｶﾞﾅ"]
[]
[]
[{"$nulls":8},"続柄",null,null,"ﾌﾘｶﾞﾅ",{"$nulls":14},"ﾌﾘｶﾞﾅ"]
[]
[]
[{"$nulls":8},"続柄",null,null,"ﾌﾘｶﾞﾅ",{"$nulls":14},"ﾌﾘｶﾞﾅ"]
[]
[]
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[null,null,"　生年月日",null,"対象者氏名",{"$nulls":6},"変更（訂正）前生年月日",{"$nulls":14},"変更（訂正）後生年月日"]
[{"$nulls":16},"年",null,null,"月",null,null,"日",{"$nulls":8},"年",null,null,"月",null,null,"日"]
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[null,null,"　性別",null,"対象者氏名",{"$nulls":6},"変更（訂正）前性別",{"$nulls":14},"変更（訂正）後性別"]
[{"$nulls":11},"　　　男　　　　　　　　女",{"$nulls":14},"　　　男　　　　　　　　女"]
[]
[null,"■住所が変わる対象者全員を記入して下さい。"]
[null,"　保険証裏面の住所は旧住所を二重線で消して新住所を記入するか、修正液などで上書きしてそのままご使用ください。　"]
[]
[null,null,"　住所・電話番号",null,"対象者氏名\n※対象者全員の氏名を記入。",{"$nulls":6},"変更（訂正）前住所",{"$nulls":14},"変更（訂正）後住所"]
[{"$nulls":11},"郵便番号",{"$nulls":6},"―",{"$nulls":7},"郵便番号",{"$nulls":6},"―"]
[]
[{"$nulls":11},"都道府県",{"$nulls":8},"都・道\n府・県",{"$nulls":5},"都道府県",{"$nulls":8},"都・道\n府・県"]
[]
[]
[]
[]
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[{"$nulls":11},"ＴＥＬ",null,null,"－　　　　　　－",{"$nulls":11},"ＴＥＬ",null,null,"－　　　　　　－"]
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[{"$nulls":33},"TGK　2021.11"]