{"text_format":"3","workbook":"xls","n_sheets":1,"sheets":["待遇申请表"],"not_rendered":{"external_links":1},"read":"whole","date_system":"1900","formulas":"cached_only"}

{"sheet":"待遇申请表","index":0,"n_rows":21,"n_cols":15,"rows_kept":21,"merged":[[0,3,1,14],[2,0,2,1],[2,2,2,10],[2,11,2,16],[3,0,3,1],[3,4,3,5],[3,7,3,8],[3,12,3,13],[3,14,3,16],[4,0,4,1],[4,6,4,8],[4,9,4,11],[4,12,4,13],[5,0,5,1],[5,10,5,11],[5,12,5,16],[6,0,6,1],[6,4,6,5],[6,12,6,13],[7,0,9,1],[7,2,7,16],[9,2,9,16],[10,0,11,1],[12,0,17,0],[12,9,17,9],[18,0,19,1],[20,0,20,16]],"flags":["formulas_cached_only"]}
[{"$nulls":3},"河南省省直职工生育保险待遇申请表"]
[]
["单位名称：",null,"郑州大学西亚斯国际学院",{"$nulls":8},"  业务受理号："]
["姓   名",{"$nulls":3},"性   别",null,null," 出生年月",{"$nulls":4}," 单位编码",null,"419900002577"]
["身份证号",{"$nulls":5},"缴费比例",null,null,{"v":0.01,"d":"1%"},null,null,"联系电话"]
[" 家庭住址",{"$nulls":9},"婚育状况",null,"（ ）初婚   （ ）再婚\n（ ）初育   （ ）再育"]
["男职工\n配偶姓名",{"$nulls":3},"身份证号",{"$nulls":7},"生育证号 "]
["申请项目类别",null,"          (  )产前检查   　        (  )生育津贴           (  )计划生育津贴  "]
[]
[null,null,"          (  )一次性生育补助金　   (  )生育医疗费　　　 　(  )计划生育医疗费"]
["申领确认",null,"    以上内容填写真实，若填写内容与实际情况不相符，承担相关法律责任。"]
[null,null,"    申领人签名：                             申领日期：     年    月   日"]
["用人单位意见",{"$nulls":8},"医保中心意见"]
[]
[]
[null,"经办人：",{"$nulls":8},"经办人："]
[{"$nulls":5},"(盖章)",{"$nulls":7},"(盖章)"]
[{"$nulls":5},"年     月     日",{"$nulls":7},"年     月     日"]
["备 注"]
[]
["说明：1、本表一式两份。\n      2、业务经办时间为每月5-20日。\n      3、需提交的材料详见生育保险待遇申领须知。"]