JPS6384369U - - Google Patents

Info

Publication number
JPS6384369U
JPS6384369U JP17969386U JP17969386U JPS6384369U JP S6384369 U JPS6384369 U JP S6384369U JP 17969386 U JP17969386 U JP 17969386U JP 17969386 U JP17969386 U JP 17969386U JP S6384369 U JPS6384369 U JP S6384369U
Authority
JP
Japan
Prior art keywords
written
rectangular frame
field
column
entry
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
JP17969386U
Other languages
Japanese (ja)
Other versions
JPH0520544Y2 (en
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed filed Critical
Priority to JP17969386U priority Critical patent/JPH0520544Y2/ja
Publication of JPS6384369U publication Critical patent/JPS6384369U/ja
Application granted granted Critical
Publication of JPH0520544Y2 publication Critical patent/JPH0520544Y2/ja
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Landscapes

  • Management, Administration, Business Operations System, And Electronic Commerce (AREA)
  • Medical Treatment And Welfare Office Work (AREA)

Description

【図面の簡単な説明】[Brief explanation of the drawing]

第1図は記入票の要部を拡大したもので受診者
IDコード、氏名記入欄、生年月日記入欄、健康
診断データ記入欄の一部を示す図、第2図は記入
票の一例の全体を示す図である。 1……記入票、7……生年月日欄(数字で記入
する欄)、14……一般健康診断欄(数字で記入
する欄)、21,23……数字記入枠、22,2
4……上下に並んだ2個の点、6……氏名欄、2
5……片仮名記入枠、26……十文字状点線、5
……記入を要しない欄、27……記入を要しない
枠。
Figure 1 is an enlarged view of the main parts of the form, showing part of the patient ID code, name field, date of birth field, and health examination data field. Figure 2 is an example of the form. It is a diagram showing the whole. 1...Entry form, 7...Date of birth column (column to fill in numbers), 14...General health examination column (column to fill in numbers), 21, 23...Number entry frame, 22,2
4...Two dots lined up one above the other, 6...Name field, 2
5...Katakana entry frame, 26...Cross-shaped dotted line, 5
...Column that does not require entry, 27...Frame that does not require entry.

Claims (1)

【実用新案登録請求の範囲】[Scope of utility model registration request] 健康診断データを手書きで記入し、光学式文字
読取り装置によつて読取らせるための記入票にお
いて、数字で記入する欄には上下に並んだ2個の
点をもつ長方形の枠を、片仮名で記入する欄には
十文字状の点線によつて4個に仕切られた長方形
の枠を、予め印字されるか記入を要しない欄には
空欄の長方形の枠を設けたことを特徴とする健康
診断データの記入票。
In the form where health examination data is written by hand and read by an optical character reader, a rectangular frame with two dots arranged one above the other is written in katakana in the column where numbers are to be written. A health checkup characterized in that a field to be filled in has a rectangular frame divided into four sections by cross-shaped dotted lines, and a blank rectangular frame is provided in a field that is preprinted or does not require entry. Data entry form.
JP17969386U 1986-11-25 1986-11-25 Expired - Lifetime JPH0520544Y2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP17969386U JPH0520544Y2 (en) 1986-11-25 1986-11-25

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP17969386U JPH0520544Y2 (en) 1986-11-25 1986-11-25

Publications (2)

Publication Number Publication Date
JPS6384369U true JPS6384369U (en) 1988-06-02
JPH0520544Y2 JPH0520544Y2 (en) 1993-05-27

Family

ID=31122975

Family Applications (1)

Application Number Title Priority Date Filing Date
JP17969386U Expired - Lifetime JPH0520544Y2 (en) 1986-11-25 1986-11-25

Country Status (1)

Country Link
JP (1) JPH0520544Y2 (en)

Also Published As

Publication number Publication date
JPH0520544Y2 (en) 1993-05-27

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