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["第36回全日本民医連呼吸器疾患研究会ｉｎ京都　【参加申込用紙】"]
["院所名　"]
["申込担当者名"]
["住所"]
["申込者への電話番号"]
["メールアドレス","送信アドレスと違う場合に記載"]
["参加者名\n\n※必ずふりがなをお願いします！","職種","11月1８日(金)",null,null,null,"１９日(土)"]
[null,null,"午前","ランチョン\nセミナー\n（食事）","午後","交流会","午前\n（食事なし）"]
["ふりがな"]
[1]
["ふりがな"]
[2]
["ふりがな"]
[3]
["ふりがな"]
[4]
["ふりがな"]
[5]
["ふりがな"]
[6]
["ふりがな"]
[7]
["ふりがな"]
[8]
[]
["※食事の注文の関係上、必ずご提出下さい。参加されるところに○を記入して下さい。"]
["※メールアドレスは必ずご記入下さい。抄録集閲覧のご案内、参加案内の送付などに利用させていただきます。"]
["※参加申込用紙は以下のメールアドレスまでご送付お願いします。 "]
["送付先：kmchikyk@zeus.eonet.ne.jp　　担当者：田中（電話：０７５－８２２－０７７７）"]