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[]
["※青色の箇所・チェック（レ点）箇所の全項目にご記入して下さい。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"NOW()","v":"2020-11-18T12:15:34.970"},null,null,null,null,null,null,null,null,null,"現在",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男","米飯","普通","なし",1,"自立","箸","義歯なし（自分の歯）","問題なし","むせなし","なし","軟飯食","0ｊ"]
["※黄色の箇所は該当の場合にご記入下さい。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女","軟飯","一口大","あり",0.75,"一部介助","スプーン","義歯なし（歯茎）","問題あり","むせあり","あり（薄いとろみ）","全粥食","0ｔ"]
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[]
["食　　　種"]
[]
[]
[]
["提供栄養量",null,null,null,null,null,"エネルギー",null,null,null,null,null,null,null,"kcal",null,null,"たんぱく質",null,null,null,null,null,null,null,"ｇ",null,null,"塩分",null,null,null,null,null,"ｇ"]
[null,null,null,null,null,null,null,null,"水分",null,null,null,null,null,"ｇ",null,null,null,null,null,"※お分かりの場合、ご記載ください。"]
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[null,null,null,null,null,null,"朝食（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
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["嚥 下 機 能",null,null,null,null,null,null,null,null,null,{"$f":"IF($G$20=\"問題あり\",\"（\",\"　\")","v":"　"},{"$f":"IF($G$20=\"問題あり\",\"副食のとろみ:\",\"　\")","v":"　"},null,null,null,null,null,null,null,{"$f":"IF(G20=\"問題あり\",\"・\",\"　\")","v":"　"},{"$f":"IF($G$20=\"問題あり\",\"水分のとろみ:\",\"　\")","v":"　"},null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(G20=\"問題あり\",\"）\",\"　\")","v":"　"}]
[null,null,null,null,null,null,null,null,null,null,{"$f":"IF($G$20=\"問題あり\",\"（\",\"　\")","v":"　"},{"$f":"IF($G$20=\"問題あり\",\"嚥下コード：\",\"　\")","v":"　"},null,null,null,null,null,null,null,null,null,null,{"$f":"IF($G$20=\"問題あり\",\"嚥下調整食分類2013　）\",\"　\")","v":"　"}]
["食品アレルギー",null,null,null,null,null,null,null,null,{"$f":"IF($G$22=\"あり\",\"（\",\"　\")","v":"　"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($G$22=\"あり\",\"）\",\"　\")","v":"　"}]
["嗜　　好",null,null,null,null,null,"好き",null,null,"（",null,null,null,null,null,null,null,null,null,null,null,null,"）",null,"嫌い",null,"（",null,null,null,null,null,null,null,null,null,null,null,null,"）"]
["栄養補助食品",null,null,null,null,null,null,null,null,null,{"$f":"IF($G$24=\"あり\",\"（\",\"　\")","v":"　"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($G$24=\"あり\",\"）\",\"　\")","v":"　"}]
["摂 食 状 況",null,null,null,null,null,null,null,null,null,{"$f":"IF(G25=\"その他\",\"（\",\"　\")","v":"　"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(G25=\"その他\",\"）\",\"　\")","v":"　"}]
["食 事 動 作",null,null,null,null,null,null,null,null,null,{"$f":"IF(G26=\"その他\",\"（\",\"　\")","v":"　"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(G26=\"その他\",\"）\",\"　\")","v":"　"}]
["使 用 器 具",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(G27=\"その他\",\"（\",\"　\")","v":"　"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(G27=\"その他\",\"）\",\"　\")","v":"　"}]
["水 分 摂 取",null,null,null,null,null,null,null,null,null,{"$f":"IF(G28=\"その他\",\"（\",\"　\")","v":"　"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(G28=\"その他\",\"）\",\"　\")","v":"　"}]
["義　　　歯"]
["身 体 問 題"]
[null,null,null,null,null,null,null,null,"（"]
[]
["備　考　欄",null,null,null,null,null,"その他食事に関わる注意事項・薬、最近の体重変化についてなど"]
[]
[]
[]
[]
["コメント欄"]
["(家族の要望等)"]