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インフルエンザ予防接種申請書兼請求書
healthadmin
This form is used to apply for and claim subsidies for influenza vaccination under the Katsushika Ward program. Applicants must attach a receipt for their out-of-pocket expenses and submit the form by mail or in person to the local health department. The submission address is the Katsushika Ward Health Department, contact number 03-3602-1231.
| What | インフルエンザ予防接種費助成事業への申請と請求 |
|---|---|
| Who | 葛飾区住民（インフルエンザ予防接種を受けた方） |
| When | 記載なし |
| Where | 葛飾区青戸4-15-14 健康プラザかつしか 2階 |
| How | 郵送または地域保健課窓口へ提出し、領収書（原本）を添付すること |
| Deadline | 記載なし |
| Contact | 03-3602-1231 |
Open the original PDF ↗ 1 pages
Source page: https://www.city.katsushika.lg.jp/kenkou/1000050/1001791/1001852.html
Checked 2026-11-01. This page restates the PDF in a fixed structure; nothing is added or removed. Where the PDF does not say, the field reads "not stated". The original Japanese PDF is authoritative — confirm dates and conditions there.