{"text_format":"3","workbook":"xlsx","n_sheets":3,"sheets":["Sheet1","Sheet2","Sheet3"],"read":"whole","date_system":"1900"}

{"sheet":"Sheet1","index":0,"n_rows":27,"n_cols":12,"rows_kept":27,"merged":[[0,0,0,11],[1,0,1,11],[2,1,2,2],[2,3,2,6],[2,7,2,11],[3,1,3,2],[3,3,3,6],[3,7,3,11],[4,0,4,11],[5,3,5,7],[5,8,5,9],[5,10,5,11],[6,0,6,11],[7,0,7,11],[8,3,8,6],[8,7,8,10],[9,1,9,2],[9,3,9,6],[10,1,10,2],[10,3,10,6],[11,1,11,2],[11,3,11,6],[12,1,12,2],[12,3,12,6],[13,1,13,2],[13,3,13,6],[14,1,14,2],[14,3,14,6],[15,1,15,2],[15,3,15,6],[16,1,16,2],[16,3,16,6],[17,1,17,2],[17,3,17,6],[18,1,18,2],[18,3,18,6],[19,1,19,2],[19,3,19,6],[20,1,20,2],[20,3,20,6],[21,1,21,2],[21,3,21,6],[22,0,22,2],[22,3,22,6],[23,0,26,0],[23,1,23,11],[24,1,24,11],[25,3,25,9],[25,10,25,11]]}
["中智公司员工子女医疗报销申请单"]
["注意事项（报销前请务必阅读）：\n1. 参加北京中智公司补充医疗保险的员工，可查阅《补充医疗保险规定》了解补充医疗保险报销的相关要求和细则。                                                                    网站浏览路径：http://www.ciicbj.com→员工服务→补充医疗、商保及其他福利篇→补充医疗规定                                                                                                  2.请参阅北京中智官网刊登的《员工报销指南》备齐、提交报销材料。\n网站路径：http://www.ciicbj.com.cn→员工快速服务通道→补充医疗、商保及其他福利篇→员工报销指南\n3. 如需在其他保险公司申请补充医疗保险报销，请注意留存单据影印件；\n4. 请将收据、明细、处方、病历一一对应，并按时间顺序进行排序整理, 特别注意：报销单据请不要粘贴;\n5. 补充医疗报销必须提供医疗费收据,明细（如有）,药费提供处方病历,检查化验提供病历,方可完成报销。"]
["姓名",null,null,"身份证号码"]
["手机号码",null,null,"电子邮箱"]
["账户信息  （请填写您本人的银行账号，用于报销款支付，医保存折及双币种信用卡暂不能支付）"]
["开户银行",null,"开户城市"," ",{"$nulls":4},"本人银行账号"]
["单及子女分割单邮寄地址、邮编：子女分割单或因缺少材料无法报销需要退回问题单据，邮寄费用请自行承担."]
[]
["子女姓名",null,"子女身份证  号码",{"$nulls":4},"是否需要子女分割单\n（如需要，请留存单据复印件） \n"]
["就诊时间","就诊医院",null,"单据金额",{"$nulls":3},"收据   张数","处方  张数","明细清单张数","病历    张数","备注"]
["       ",{"$nulls":6},"    ","    ","    ",null,"      "]
{"$rows_empty":11}
["申请总金额（请累计收据票面总金额）: "]
["签字栏","本人保证上述各项填报及所提供材料均真实、准确，如有不实，本人愿意承担一切责任;"]
[null,"如此表由他人代为填写，责任由本人承担。"]
[{"$nulls":3},"申请人签字（必填）："]
[{"$nulls":3},"申请日期：",{"$nulls":3},"年",null,"月",null,"   日"]

{"sheet":"Sheet2","index":1,"n_rows":0,"n_cols":0,"rows_kept":0}

{"sheet":"Sheet3","index":2,"n_rows":0,"n_cols":0,"rows_kept":0}