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["令和　 　年分　医療費控除の明細書"]
[null,null,"※この控除を受ける方は、セルフメディケーション税制は受けられません。"]
["住所　　　　　　　　                                                             　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　"]
[]
["氏名　　　　　　　　　                                                             　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　"]
[]
[]
["１　医療費通知に関する事項\n医療費通知を添付する場合、右記の(1)～(3)を記入してください。\n（注） 医療費通知には前年支払分の医療費が記載されている場合がありますのでご注意ください。",null,null,null,"(1)医療費通知に記載された\n医療費の額（自己負担額）",null,"(2) (1)のうちその年中\nに実際に支払った\n医療費の額",null,null,"(3) (2)のうち保険金等\nで補填される金額"]
[]
[null,null,null,null,null,"円","㋐",null,"円","㋑",null,"円"]
[]
[]
[null,null,null,null,null,null,null,"領収書1枚ごとではなく、医療を受けた方・\n病院等ごとにまとめて記入できます"]
[]
[]
["２　医療費（上記１以外）の明細（通知書に記載されているものは記入しないでください）"]
["(1)医療費を\n受けた方の氏名","(2)病院・薬局などの\n名称",null,null,"(3)医療費の区分","(4)支払った医療費の額",null,null,null,"(5)左のうち保険金等で\n補填される金額"]
[null,null,null,null,null,null,null,null,"円",null,null,"円"]
[null,null,null,null,null,null,null,null,"円",null,null,"円"]
[null,null,null,null,null,null,null,null,"円",null,null,"円"]
[null,null,null,null,null,null,null,null,"円",null,null,"円"]
[null,null,null,null,null,null,null,null,"円",null,null,"円"]
[null,null,null,null,null,null,null,null,"円",null,null,"円"]
[null,null,null,null,null,null,null,null,"円",null,null,"円"]
[null,null,null,null,null,null,null,null,"円",null,null,"円"]
["２　　の　　合　　計",null,null,null,null,"㋒",null,{"$f":"IF(SUM(F18:F25)<>0,SUM(F18:F25),\"\")","v":""},"円","㋓",{"$f":"IF(SUM(J18:J25)=\"\",\"\",IF(SUM(J18:J25)<>0,SUM(J18:J25),\"\"))","v":""},"円"]
[]
["医　　療　　費　　の　　合　　計",null,null,null,null,"㋐＋㋒",null,{"$f":"IF(SUM(F26,H10,'2枚目'!E30)<>0,SUM(H26,H10,'2枚目'!E30),\"\")","v":""},"円","㋑＋㋓",{"$f":"IF(SUM(K26,K10,'2枚目'!G30)<>0,SUM(K26,K10,'2枚目'!G30),\"\")","v":""},"円"]
[]
["3　控除額の計算"]
["①支払った医療費",null,{"$f":"H28","v":""},"円",null,null,null,null,null,{"$f":"IF(SUM(F18:F25,F10,'2枚目'!C30)<>0,SUM(F18:F25,F10,'2枚目'!C30),\"0\")","v":"0"},null,{"$f":"IF(SUM(F18:F25,H10,'2枚目'!E30)<>0,SUM(F18:F25,H10,'2枚目'!E30),\"0\")","v":"0"},{"$f":"IF(SUM(J18:J25,K10,'2枚目'!G30)<>0,SUM(J18:J25,K10,'2枚目'!G30),\"0\")","v":"0"}]
[]
["②保険金などで\n補てんされる金額",null,{"$f":"K28","v":""},"円"]
[]
["③差引金額（①－②）",null,{"$f":"IF(AND(C31=\"\",C33=\"\"),\"\",IF(L31-M31>0,L31-M31,IF(L31-M31<0,\"\",IF(L31-M31=0,\"0\"))))","v":""},"円"]
[]
["④所得金額の合計額",null,null,"円"]
[]
["⑤所得金額×5%\n（④×5％）",null,{"$f":"IF(C37=\"\",\"\",IF(ROUNDDOWN(C37*0.05,0)<=0,0,ROUNDDOWN(C37*0.05,0)))","v":""},"円"]
[]
["⑥ ⑤と10万円のいずれか少ない方の金額",null,{"$f":"IF(C37=\"\",\"\",IF((ROUNDDOWN(C37*0.05,0))<=0,\"0\",IF(C39<100000,C39,100000)))","v":""},"円"]
[]
["医療費控除額（③－⑥）",null,{"$f":"IF(C37=\"\",\"\",IF(SUM(C35)-SUM(C41)<=0,\"0\",SUM(C35)-SUM(C41)))","v":""},"円"]
["（控除額は最高で２００万円）"]

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["令和　  　年分　医療費控除の明細書"]
[]
[null,null,"※この控除を受ける方は、セルフメディケーション税制は受けられません。"]
["住所　　　　　　　　                                                             　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　"]
[]
["氏名　　　　　　　　　                                                             　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　"]
[]
["２　医療費（上記１以外）の明細（通知書に記載されているものは記入しないでください）"]
["(1)医療費を\n受けた方の氏名","(2)病院薬局などの\n名称",null,"(3)医療費の区分","(4)支払った医療費の額",null,"(5)左のうち保険金等で\n補てんされる金額"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
[null,null,null,null,null,"円",null,"円"]
["合　　計",null,null,null,{"$f":"IF(SUM(E10:E29)<>0,SUM(E10:E29),\"\")","v":""},"円",{"$f":"IF(SUM(G10:G29)=\"\",\"\",IF(SUM(G10:G29)<>0,SUM(G10:G29),\"\"))","v":""},"円"]