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[null,"２０２２年　新型コロナウイルス　健康観察チェックシート（役員・選手）"]
[null,"大学名",{"$nulls":6},"氏  名",null,"男 ・ 女　　"]
[null,"住  所",{"$nulls":12},"連絡先　　　\n（電話、メール等）"]
[null,"移動・滞在先","（例：●月▲～◆日，東京）",{"$nulls":11},"ワクチン接種の有無",null,null,null,"1回目：　　　月　　　　日　　　2回目：　　　月　　　　日　　3回目：　　　月　　　　日"]
[null,null,"1日目","2日目","3日目",null,"4日目",null,"5日目",null,"6日目",null,"7日目",null,"8日目",null,"9日目",null,"10日目",null,"11日目",null,"12日目",null,"13日目",null,"14日目",null,"15日目"]
[null,"日付","4月28日","4月29日","4月30日",null,"5月1日",null,"5月2日",null,"5月3日",null,"5月4日",null,"5月5日",null,"5月6日",null,"5月7日",null,"5月8日",null,"5月9日",null,"5月10日",null,"5月11日",null,"5月12日"]
[null,"体温","       ℃","       ℃","       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃",null,"       ℃"]
[]
[null,"せき"]
[null,"呼吸困難"]
[null,"鼻汁・鼻閉"]
[null,"咽頭痛"]
[null,"頭痛"]
[null,"下痢"]
[null,"おう吐"]
[null,"だるい"]
[null,"その他症状"]
[null,"備考欄"]
[{"$nulls":12},"※せき、呼吸困難等の症状につきましては、該当するところに「〇」をつけてください。"]
[{"$nulls":12},"※虚偽の申請は社会的に多大な損害をもたらすことがあります。"]
[{"$nulls":12},"※プリントアウトして、各チームでとりまとめ、大会当日の試合前に本部に提出すること。"]