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[null,"No","医療福祉関連産業参入チャレンジ企業　登録申請書",null,null,null,null,null,null,"記入者"]
[]
[]
[null,"企業名",null,null,null,null,"本社住所"]
[null,null,null,null,null,null,"開発拠点"]
[null,"代表者名",null,null,null,null,"役職"]
[null,"設立年",null,"資本金",null,"電話",null,null,"FAX"]
[null,"業種",null,null,null,"得意技術\n製品"]
[null,"従業員数",null,"開発技術者"]
[null,"訪問日"]
[null,"企業対応者",null,null,null,"HPアドレス"]
[null,"連絡担当者",null,null,null,"e-mail"]
[null,"医療・福祉関連産業への参入状況"]
[null,"現状","参入状況について"]
[null,null,"製品名",null,null,null,null,null,"売上"]
[null,null,"製品名",null,null,null,null,null,"売上"]
[null,"将来","今後の参入について"]
[]
[]
[null,null,"参入を計画又は検討している分野"]
[null,null,"具体的製品イメージ",null,"有　　無"]
[null,"参入する上での\n課題"]
[]
[]
[null,"希望する支援"]
[]
[]
[null,"備考"]