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[null,null,"建　退　共　運　営　報　告　書",null,null,null,null,null,null,null,null,null,null,null,null,null,"工   事   名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"工　　　　 期",null,null,"　令和　　年　　月　　日　　　から　　　令和　　　年　　　月　　　日"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"受 注 者 名"]
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[null,"工　　　種",null,null,null,null,"職種",null,null,"年度",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"合計"]
[null,null,null,null,null,null,null,null,null,"４月",null,"５月",null,"６月",null,"７月",null,"８月",null,"９月",null,"10月",null,"11月",null,"12月",null,"１月",null,"２月",null,"３月"]
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[null,"合　　　計"]
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[null,"対 象 者 累 計"]
[null,"証 紙 購 入 枚 数"]
[null,"証 紙 残 枚 数"]