JPH0241974U - - Google Patents

Info

Publication number
JPH0241974U
JPH0241974U JP11890088U JP11890088U JPH0241974U JP H0241974 U JPH0241974 U JP H0241974U JP 11890088 U JP11890088 U JP 11890088U JP 11890088 U JP11890088 U JP 11890088U JP H0241974 U JPH0241974 U JP H0241974U
Authority
JP
Japan
Prior art keywords
inspection
request form
items
field
paper
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
JP11890088U
Other languages
Japanese (ja)
Other versions
JPH0642870Y2 (en
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed filed Critical
Priority to JP1988118900U priority Critical patent/JPH0642870Y2/en
Publication of JPH0241974U publication Critical patent/JPH0241974U/ja
Application granted granted Critical
Publication of JPH0642870Y2 publication Critical patent/JPH0642870Y2/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Landscapes

  • Character Input (AREA)
  • Credit Cards Or The Like (AREA)

Description

【図面の簡単な説明】[Brief explanation of drawings]

図面はこの考案の一実施例に係る検査依頼書を
示しており、第１図はラベル紙片の横成を示す平
面図、第２図は２枚目の紙片の構成を示す平面図
、第３図は３枚目の紙片の構成を示す平面図、第
４図は４枚目の紙片の構成を示す平面図、第５図
はチエツクマーク欄の構成を拡大して示す説明図
、第６図は診察券カードの表面図、第７図は転写
装置の一例を示す斜視図である。 〔符号の説明〕、２０……２枚目の紙片、３０
……３枚目の紙片、４０……４枚目の紙片、２３
……検査項目欄、２３Ａ，３３Ａ，４３Ａ……Ｏ
ＣＲ読取り用追加項目欄。 The drawings show an inspection request form according to an embodiment of this invention, in which Fig. 1 is a plan view showing the formation of label paper strips, Fig. 2 is a plan view showing the structure of the second paper strip, and Fig. 3 is a plan view showing the configuration of the second paper strip. Figure 4 is a plan view showing the configuration of the third piece of paper, Figure 4 is a plan view showing the configuration of the fourth piece of paper, Figure 5 is an explanatory diagram showing the configuration of the check mark column on an enlarged scale, and Figure 6 7 is a front view of the medical examination card, and FIG. 7 is a perspective view showing an example of a transfer device. [Explanation of symbols], 20...Second piece of paper, 30
...3rd piece of paper, 40...4th piece of paper, 23
...Inspection item column, 23A, 33A, 43A...O
Additional item column for CR reading.

Claims (1)

【実用新案登録請求の範囲】[Scope of utility model registration request] ＯＭＲで読取り可能なチエツクマーク欄を有す
る検査項目欄が形成されてなる検査依頼書におい
て、上記検査依頼書の一部には、予め印刷された
上記検査項目以外の追加項目を記入するＯＣＲ読
取り用項目追加欄が形成されていることを特徴と
する検査依頼書。 In an inspection request form that includes an inspection item field with a check mark field that can be read by OMR, a part of the inspection request form includes an OCR readable mark for writing additional items other than the pre-printed inspection items. An inspection request form characterized in that an additional item column is formed.
JP1988118900U 1988-09-12 1988-09-12 Inspection request form Expired - Lifetime JPH0642870Y2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP1988118900U JPH0642870Y2 (en) 1988-09-12 1988-09-12 Inspection request form

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP1988118900U JPH0642870Y2 (en) 1988-09-12 1988-09-12 Inspection request form

Publications (2)

Publication Number Publication Date
JPH0241974U true JPH0241974U (en) 1990-03-22
JPH0642870Y2 JPH0642870Y2 (en) 1994-11-09

Family

ID=31363657

Family Applications (1)

Application Number Title Priority Date Filing Date
JP1988118900U Expired - Lifetime JPH0642870Y2 (en) 1988-09-12 1988-09-12 Inspection request form

Country Status (1)

Country Link
JP (1) JPH0642870Y2 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2023098790A (en) * 2021-12-29 2023-07-11 賢治 藤井 Sample test request support system

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS56118673A (en) * 1980-02-26 1981-09-17 Olympus Optical Co Ltd Test application card for automatic analysis means
JPS579563U (en) * 1980-06-16 1982-01-19
JPS5812072A (en) * 1981-07-13 1983-01-24 Fujitsu General Ltd Reading device for various data formats
JPS5968260U (en) * 1982-10-28 1984-05-09 社団法人松山市医師会 Clinical test instruction sheet

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS56118673A (en) * 1980-02-26 1981-09-17 Olympus Optical Co Ltd Test application card for automatic analysis means
JPS579563U (en) * 1980-06-16 1982-01-19
JPS5812072A (en) * 1981-07-13 1983-01-24 Fujitsu General Ltd Reading device for various data formats
JPS5968260U (en) * 1982-10-28 1984-05-09 社団法人松山市医師会 Clinical test instruction sheet

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2023098790A (en) * 2021-12-29 2023-07-11 賢治 藤井 Sample test request support system

Also Published As

Publication number Publication date
JPH0642870Y2 (en) 1994-11-09

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