{"text_format":"3","workbook":"xls","n_sheets":6,"sheets":["本校备案表","异地表","补贴奖励申领","护、围审核","生育、计划生育手术汇总表","配偶无工作"],"read":"whole","date_system":"1900","formulas":"cached_only"}

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["吉林师范大学生育备案表"]
[{"$nulls":5},"申 报 日 期：","年   月   日"]
["姓    名",null,null,"性  别",null,"工  号"]
["身份证号",{"$nulls":4},"联系电话"]
["所在单位",{"$nulls":3},"预产期"]
["定点医院"]
["备注（几孩）"]
["人事处情况确认",null,"公章",{"$nulls":3},"年   月   日"]
[]
["注意事项："]
["1.定点医院在申报后不能随意更改，需出具转诊手续，私自转院不能报销。"]
["2.只有发生在定点医院的费用才能报销。"]
[]
["3.门诊报销有限额（1300），仅限检查费用，需自费（使用医保卡不能报销）保留收据，费用在生产后一起报销。"]
[]
["4.怀孕期间涉及保胎住院需自费，保存收据、病历、费用清单等，在生产后一起报销。"]
[]
["5.享受异地安置政策的教职工，同样需要自费后回四平医保报销。"]
[]
["6.生育报销在生育158天后1年内办理，超期将不能报销"]
[]
[]
["如果医保政策有变更，以医保政策为准"]
["请仔细阅读注意事项的内容，如无异议，请在右侧签字确认",{"$nulls":4},"个人签字","年   月   日"]

{"sheet":"异地表","index":1,"n_rows":19,"n_cols":10,"rows_kept":19,"merged":[[0,0,0,9],[1,6,1,7],[1,9,4,9],[2,0,3,0],[2,1,2,8],[3,1,3,8],[4,1,4,8],[5,0,6,0],[5,1,6,5],[5,6,6,7],[5,8,5,9],[6,8,6,9],[7,0,10,0],[7,1,7,9],[8,1,8,8],[11,0,12,0],[11,1,11,5],[11,6,11,9],[12,1,12,5],[12,6,12,9],[13,0,18,0],[13,1,13,5],[13,6,18,6],[13,7,13,9],[14,1,14,5],[14,7,14,9],[15,1,15,5],[15,7,15,9],[16,1,16,5],[16,7,16,9],[17,4,17,5],[17,7,18,8],[18,4,18,5]],"flags":["formulas_cached_only"]}
["医疗工伤生育保险异地居住就医申请表"]
["姓 名",null,"性别",null,"年龄",null,"医疗保险\n编    号",null,null,"1寸彩色\n免  冠\n照  片"]
["类 别","灵活就业人员□   普通居民□   学生及18周岁以下未成年人□"]
[null,"在职□  退休□  工伤□  保健对象□  劳动模范□  建前退休人员□"]
["异地\n地址","           省        市         区         街（路）         号"]
["异地\n联系\n电话",{"$nulls":5},"异地形式",null,"异地医疗  □"]
[{"$nulls":8},"异地生育  □"]
["所在\n单位\n确认\n情况","主要情况（个人参保无需填写）:\n\n\n                                               \n                                  \n\n                                               "]
[null,"审核人：_________  联系电话：_________"]
[{"$nulls":8},"   （公章）"]
[{"$nulls":8}," 年   月   日"]
["（异地居住地）\n选定医疗机构","三级医院：\n（填写全称）",{"$nulls":4},"二级医院：\n（填写全称）"]
[null,"一级医院：\n（填写全称）",{"$nulls":4},"专科医院：\n（填写全称）"]
["确认情况\n异地居住地医疗保险管理机构","上述医疗机构的类型和级别是否属实",{"$nulls":4},"统筹地区经办机构审核情况","办理时间：     年   月   日"]
[null,"     是 □           否 □",{"$nulls":5},"生效时间：     年   月   日"]
[null,"其他需要说明的情况：",{"$nulls":5},"终止时间：     年   月   日"]
[{"$nulls":7},"审核人：         审批人："]
[{"$nulls":4},"  （盖章）",{"$nulls":4},"（盖章）"]
[{"$nulls":4},"年  月  日",{"$nulls":4},"年  月  日"]

{"sheet":"补贴奖励申领","index":2,"n_rows":32,"n_cols":9,"rows_kept":32,"merged":[[0,0,0,9],[2,0,2,9],[3,0,3,1],[3,2,3,3],[4,0,4,1],[4,2,4,5],[4,6,4,7],[4,8,4,9],[5,0,5,1],[5,6,5,9],[6,0,6,9],[7,0,8,2],[7,3,7,5],[7,7,7,9],[8,3,8,6],[8,7,8,8],[9,0,9,9],[10,0,10,1],[10,2,10,5],[10,7,10,9],[11,0,11,1],[11,2,11,5],[11,7,11,9],[12,0,12,9],[13,0,13,1],[13,2,13,3],[13,7,13,9],[14,0,14,1],[14,2,14,5],[14,7,14,9],[15,0,15,9],[16,0,27,1],[29,0,30,9],[31,0,32,9]],"flags":["formulas_cached_only"]}
["生育保险补贴奖励申领表"]
[]
["   申请人信息"]
["姓名",{"$nulls":3},"性别",null,"年龄",null,"医保编号"]
["工作单位",null,"吉林师范大学",{"$nulls":3},"身份证号"]
["联系电话",null,"     （固话）",{"$nulls":3},"（手机）"]
["   申领项目"]
["申领项目",null,null,"   护理补贴 （   ） ",{"$nulls":3},"围产补贴  （    ）"]
[{"$nulls":3},"   无工作男职工配偶围产补贴（   ）",{"$nulls":3},"独生子女奖励（   ）"]
["   配偶信息"]
["姓名",{"$nulls":5},"身份证号"]
["结婚证号",{"$nulls":5},"工作单位"]
["  子女信息"]
["子女姓名",{"$nulls":3},"性别",null,"出生日期"]
["身份证号",{"$nulls":5},"户口所在地"]
["  审批信息"]
["单         位         审         核         意         见"]
[]
[]
[]
[{"$nulls":6},"（加盖公章）"]
[]
[]
[]
[{"$nulls":3},"审核人：   ",null,"联系电话："]
[]
[]
[{"$nulls":7},"年   月   日"]
[]
["注：1、办理生育保险护理补贴、围产补贴需提供结婚证和子女户口本原件及复印件，无工作男职工配偶领取补贴，须同时提供经办机构生育费用报销凭证（未报销生育费用的需提供女方失业证明）。                     "]
[]
["   2、办理独生子女奖励需提供《独生子女光荣证》（原件及复印件），无子女、离婚后再婚未育和合法收养子女的退休人员，需由单位人事部门开具有效证明，参保人员退休时独生子女死亡的需要派出所开具有效证明。"]

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["生育保险生育护理补贴、围产补贴审核表"]
[]
[]
["单位名称：（公章）",{"$nulls":4},"报送日期："]
["序号","申请人姓名","性    别","年龄","医保编号","身份证号码","护理补贴","围产期补贴"]
[1]
[2]
[3]
[4]
[5,{"$nulls":9},"                                "]
[6]
[7]
[8]
[9]
[10]
[]
[null,"填报人：",null,null,"联系电话："]
[]
[null,"经办机构审核人：",null,null,"     经办机构复核人："]

{"sheet":"生育、计划生育手术汇总表","index":4,"n_rows":18,"n_cols":14,"rows_kept":18,"merged":[[0,0,0,13],[1,0,1,3],[1,5,1,6],[2,0,4,0],[2,1,4,1],[2,2,4,2],[2,3,4,3],[2,4,4,4],[2,5,4,5],[2,6,2,9],[2,10,2,13],[3,6,3,7],[3,8,3,9],[3,10,3,11],[3,12,3,13],[15,0,15,2],[15,6,15,8],[16,4,16,5],[17,0,17,3],[17,6,17,9]],"flags":["formulas_cached_only"]}
["生育保险计划生育手术、生育医疗费审核表"]
["单位名称：（公章）",{"$nulls":4},"报送日期："]
["序号","申请人姓名","性    别","年龄","医保编号","身份证号码","计划生育手术医疗费",{"$nulls":3},"生育医疗费"]
[{"$nulls":6},"门诊",null,"住院",null,"门诊",null,"住院"]
[{"$nulls":6},"收据张数","金额","收据张数","金额","收据张数","金额","收据张数","金额"]
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
["填报人：",{"$nulls":5},"   联系电话："]
[]
["经办机构审核人：",{"$nulls":5},"    经办机构复核人："]

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["生育保险无工作男职工配偶生育待遇申请表"]
[]
["男职工姓名",null,null,"医疗保险                      编号",null,"联系电话"]
["工作单位",{"$nulls":4},"单位电话"]
["配偶姓名",null,null,"年龄",null,"身份证号"]
["妊娠日期",{"$nulls":3},"预产期"]
["失业证编号",{"$nulls":3},"户口所在地"]
["结婚证号",{"$nulls":3},"选定医院"]
["单             位             审             核             情             况 "]
[null,null,"主要情况："]
[null,null,"审核人：",null,"联系电话：",null,"（盖章）"]
[{"$nulls":6},"年   月   日"]
["经             办             机             构                审               核               情               况"]
[null,null,"核定人签章："]
[null,null,"审核人签章：",null," ",null,"（业务章）"]
[{"$nulls":6},"年   月   日"]