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["2019年度　臨床研究セミナー　e-learning 用　受講確認票"]
["受講セミナー","受講したセミナーの□にチェックを入れてください。→",null,"第10回　くすりの費用対効果評価とは？　－国内外の医療経済評価の実際ー"]
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["受講者情報","記入日：","西暦",20,null,"年",null,"月",null,"日"]
[null,"所属："]
[null,null,"【部署名：                　    　　　   】",null,null,null,null,null,null,null,"センター ・ 科 ・ 部 ・ 病棟 ・ 教室 ・ 課"]
[null,"職員番号(学籍番号）：",null,null,null,null,null,null,null,null,"←右詰めで記入してください。番号がない方は記載不要です。"]
[null,"氏名："]
[null,"メールアドレス：",null,null,null,null,null,null,null,"＠"]
[null,"ＭＰＳ番号（内線）：",null,null,null,null,null,null,"←問合せの際に確実に連絡がとれる番号を記入してください。"]
[null,"職種："]
[null,"当てはまるものがない場合は「その他」をチェックし職種を記入してください。"]
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["動画を視聴した後に動画受講の感想を300～400字程度で以下に記載、もしくはword等で作成した文書を添付してください。未記載は受講を無効とします。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"入力時目安"]
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["アンケート記載欄："]
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["【提出方法】庁内メール便もしくはメールにて下記「提出先」に送付してください。*個人情報が含まれますので取り扱いにはご注意ください。"]
["【提出先】横浜市立大学附属病院 次世代臨床研究センター　教育研修室　　"]
["【問合せ先】 ☎045-370-7949（内線3573） 　📠045-370-7943　　📧 ynextedu@yokohama-cu.ac.jp"]