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["    （別紙１）",null,"小動物（犬、猫、鳥類、ウサギ）"]
[]
["診　　療　　年　　報"]
[{"$nulls":14},"　　年　　月　　日"]
[]
["　北海道知事　様"]
[]
[{"$nulls":6},"住所"]
[{"$nulls":6},"氏名（病院名）"]
[{"$nulls":6},"連絡先（TEL、FAX、E-mail）"]
[]
["　　　　　　年に診療した飼育動物について、獣医療法施行細則第４条の規定により、次のとおり報告します。"]
[]
["動物種 ：",{"$nulls":4},"（動物種ごとに別葉としてください）"]
[]
["病類","病　名",null,"１月","２月","３月","４月","５月","６月","７月","８月","９月","１０月","１１月","１２月","計","備考"]
[]
["中毒","農薬中毒",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"殺鼠剤・殺虫剤中毒",{"$nulls":13},0]
[{"$nulls":15},0]
["ウイ\nルス\n病","ウイルス性\n呼吸器感染症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"ウイルス性\n下痢感染症",{"$nulls":13},0]
[{"$nulls":15},0]
["細菌及び真菌病","レプトスピラ症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"サルモネラ症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"結核病",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"皮膚真菌症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"オウム病",{"$nulls":13},0]
[{"$nulls":15},0]
["原虫及び寄生虫病","トキソプラズマ病",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"コクシジウム病",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"回虫症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"エキノコックス症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"犬糸状虫症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"マダニ寄生\n（ライム病を含む）",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"ツメダニ症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"疥癬症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"ノミ感染症",{"$nulls":13},0]
[{"$nulls":15},0]
[null,"シラミ感染症",{"$nulls":13},0]
[{"$nulls":15},0]
[]
["注 １　　上段は診療頭羽数、下段は死亡頭羽数を記入してください。"]
["　　２　　レプトスピラ症は犬で監視伝染病に指定された血清型（ポモナ､カニコーラ､イクテロヘモリジア､フリポティフォー\n　　　　サ､ハージョ､オータムナリス､オーストラーリス）を除いてください。"]

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["（別添１）"]
[]
["飼育動物診療年報の病類・病名記載区分表 （小動物）"]
[]
["ア　病類について"]
["　　次により、犬、猫、鳥類及びウサギの畜種別に分類する。"]
["病　類","内　　　　　　　　　　容"]
["中　毒","化学的因子が原因となり発病し、人への影響等がある疾病名を分類すること。"]
["ウイルス病","ウイルスの感染により発病する、予防衛生の観点から把握が必要な呼吸器及び\n下痢感染症に分類すること。"]
["細菌及び\n真菌症","ウイルス性以外の細菌・真菌等により発病する人獣共通感染症等の疾病名を\n分類すること。"]
["原虫及び\n寄生虫病","原虫・寄生虫により発病する人獣共通感染症及び予防衛生の面から把握が必要な\n疾病名を分類すること。"]
[]
[]
["イ　病名について"]
["　　次の病名記載区分表に基づき、病名ごとに分類する。"]
[]
["［病名記載区分表］"]
[]
["病　　類","病　　　　名"]
["中　毒","農薬中毒"]
[null,"殺鼠剤・殺虫剤中毒"]
["ウイルス病","ウイルス性呼吸器感染症"]
[null,"ウイルス性下痢感染症"]
["細菌及び\n真菌病","レプトスピラ症"]
[null,"サルモネラ症"]
[null,"結核病"]
[null,"皮膚真菌症"]
[null,"オウム病"]
["原虫及び\n寄生虫病","トキソプラズマ病"]
[null,"コクシジウム病"]
[null,"回虫症"]
[null,"エキノコックス症"]
[null,"犬糸状虫症"]
[null,"マダニ寄生（ライム病を含む）"]
[null,"ツメダニ症"]
[null,"疥癬症"]
[null,"ノミ感染症"]
[null,"シラミ感染症"]