\documentclass[12pt]{jarticle}
\pagestyle{empty}
\setlength{\oddsidemargin}{-0.5cm}
\setlength{\topmargin}{-0.5cm}
\setlength{\headheight}{0cm}
\setlength{\headsep}{0cm}
\setlength{\textwidth}{18.5cm}



\begin{document}
\def\出張{
\thicklines
\put(6.2,17.55){\line(1,0){1.65}}\put(6.2,17.65){\line(1,0){1.65}}
\put(7.2,24.3){\line(1,0){1.9}}\put(7.2,24.4){\line(1,0){1.9}}
\thinlines
}
\def\研修{
\thicklines
\put(6.2,18.65){\line(1,0){1.65}}\put(6.2,18.75){\line(1,0){1.65}}
\put(7.2,25.15){\line(1,0){1.9}}\put(7.2,25.25){\line(1,0){1.9}}
\thinlines
}
\def\公費{\put(3.8,8.5){レ}}  %  公費
\def\私費{\put(3.8,5.9){レ}}  %  私費
\def\運営費交付金{\put(7.0,10.7){レ}}%運営費交付金等
\def\委任経理金{\put(7.0,10.2){レ}}%委任経理金
\def\科学研究費{\put(7.0, 9.7){レ}}%科学研究費等
\def\個人研究費{\put(7.0,9.1){レ}}%個人研究費
\def\講座共通費{\put(7.0,8.6){レ}}%講座共通費
\def\その他{\put(7.0,8.1){レ}}%その他
\def\学部修士予算{\put(10.35,9.1){レ}}%学部修士予算
\def\連合大学院予算{\put(14.0,9.1){レ}}%連大予算
\def\教育経費{\put(7.0,7.0){レ}}%教育経費
\def\研究経費{\put(7.0,6.5){レ}}%研究経費
\def\sphyogo{\hspace{4.5mm}}
\def\spm{\hspace{-0.5mm}}
\begin{figure}[ht]
\unitlength=1.0cm
\begin{picture}(16.6,25.5)


%----------------------ここから上は変更しないでください
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
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%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
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%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%出張か研修のどちらかを選んでください。
%出張なら \出張
%研修なら \研修
%
\出張
%\研修
%今日の日付 yy=年 mm=月 dd=日
\def\yy{16}
\def\mm{04}
\def\dd{16}
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%所属 官職 名前
%
\def\所属{自然系教育講座}
\def\官職{教 授}
\def\名前{だれ \quad それ}
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%出張 もしくは 研修の期間 yyb年mmb月ddb日 から yye年mme月dde日まで
%
\def\yyb{16}
\def\mmb{04}
\def\ddb{19}
%
\def\yye{16}
\def\mme{04}
\def\dde{19}
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%用務：３行まで書けます。１行だけなら ２行目に書くのがいいでしょう。
%
\def\用務１行目{重要で、}
\def\用務２行目{大事な、}
\def\用務３行目{研究打ち合わせ}
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%用務先
%
\def\用務先{ほげほげ大学}
\def\用務先住所{ほげほげ県 ほげほげ市}
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%旅費欄
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%公費か私費のいずれかを選んでください。
%    公費なら \公費、 私費なら \私費
%
\公費
%\私費
%
%%%%%公費の場合%%%%%%%%%%%%%%%%%%%%%%%%
%
%財源区分を選んでください
%    運営交付金等なら \運営交付金
%    委任経理金  なら \委任経理金
%    科学研究費等なら \科学研究費
%
\運営費交付金
%\委任経理金
%\科学研究費
%
%%%%委任経理金の場合
\def\寄付金名称{}

%%%%科学研究費の場合
\def\課題番号{}

%
%%%%%運営交付金等の場合%%%%%%%%%%%%%%%%
%
%所轄を選んでください
%    個人研究費なら \個人研究費
%    講座共通費なら \講座共通費
%    その他    なら \その他
%
\個人研究費
%\講座共通費
%\その他
%
%%%%個人研究費のときは
%
%学部修士予算か 連合大学院予算かを選んでください
%
\学部修士予算
%\連合大学院予算
%
%%%%講座共通費のときは
\def\講座共通費名{}

%%%%その他のときは
\def\プロジェクト名{}

%
%%%%%運営交付金等の場合%%%%%%%%%%%%%%%%
%
%目的を選んでください 
%    教育経費なら  \教育経費
%    研究経費なら  \研究経費
%
%\教育経費
\研究経費
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%
%連絡先
%
\def\連絡先名{ ほげほげ研究室}
\def\連絡先電話番号{ ***-****-*****}
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%
%備考
%
\def\備考{}
%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
%------------------ここから先は変更しないでください。
%\thicklines
\put(0,23.6){\line(1,0){16.6}}	%
\put(0,23.6){\line(0,-1){20.6}}	%   枠線
\put(16.6,3.0){\line(-1,0){16.6}}	%
\put(16.6,3.0){\line(0,1){20.6}}	%

\put(0,16.9){\line(1,0){16.6}}	%   横線
\put(0,15.3){\line(1,0){16.6}}	%   横線
\put(0,13.1){\line(1,0){16.6}}	%   横線
\put(0,11.0){\line(1,0){16.6}}	%   横線
\put(0, 5.6){\line(1,0){16.6}}	%   横線
\put(0, 4.0){\line(1,0){16.6}}	%   横線

\put(3.6,3.0){\line(0,1){13.9}}	%   縦線

\put(3.6,6.2){\line(1,0){13.0}}	%   横線

\put(4.4,6.2){\line(0,1){ 4.8}}	%   縦線
\put(6.7,6.2){\line(0,1){ 4.8}}	%   縦線

\put(4.4,7.8){\line(1,0){12.2}}	%   横線
\put(4.4,9.4){\line(1,0){12.2}}	%   横線


\put(0,2.4){\line(1,0){16.6}}	%   下の枠
\put(0,0.0){\line(1,0){16.6}}	%   
\put(0,0.0){\line(0,1){2.4}}	%   
\put(16.6,0.0){\line(0,1){2.4}}	%   


\put( 3.6,0.0){\line(0,1){2.4}}	%   縦線
\put( 5.5,0.0){\line(0,1){2.4}}	%   縦線
\put( 7.4,0.0){\line(0,1){2.4}}	%   縦線
\put( 9.9,0.0){\line(0,1){2.4}}	%   縦線
\put(12.2,0.0){\line(0,1){2.4}}	%   縦線
\put( 3.6,1.2){\line(1,0){8.6}}	%   横線


\put(7.3,24.2){{研\qquad 修}}
\put(7.3,25.1){{出\qquad 張}}
\put(10.7,24.6){{伺}}




\put(11.4,22.5){ 平成\hspace{2.5mm} \yy 年\hspace{2.5mm} \mm 月\hspace{2.5mm} \dd 日}


\put(0.7,21.9){
兵\sphyogo 庫\sphyogo 教\sphyogo 育\sphyogo 大\sphyogo 学\sphyogo 長
\sphyogo \sphyogo 殿}


\put(8.2,20.9){所属講座等\phantom{空空空} \所属 }
\put(8.2,20.2){職\phantom{属講座}名 \phantom{空空空} \官職 }
\put(8.2,19.5){氏\phantom{属講座}名 \phantom{空空空} \名前 }


\put(15.5,19.5){\small 印}


\put(3.1,18.0){下記のとおり \hspace{2.6cm} したいのでお伺いします。}
\put(6.2,18.6){出\qquad 張}
\put(6.2,17.5){研\qquad 修}


\put(0.7,15.9){期\phantom{中中中}間}
\put(0.7,14.0){用\phantom{中中中}務}

\put(0.7,11.9){用\phantom{中}務\phantom{中}先}
\put(0.7,8.4){旅\phantom{中中中}費}
\put(0.7,4.6){連\phantom{中}絡\phantom{中}先}
\put(0.7,3.3){備\phantom{中中中}考}


\put(4.0,15.9){
平成\phantom{空}\yyb 年
\phantom{空}\mmb 月
\phantom{空}\ddb 日から 
平成\phantom{空}\yye 年
\phantom{空}\mme 月
\phantom{空}\dde 日まで}



\put(4.0,14.5){\用務１行目}
\put(4.0,14.0){\用務２行目}
\put(4.0,13.5){\用務３行目}



\put(4.0,12.65){名\phantom{空}称\quad }
\put(6.0,12.65){\用務先}
\put(4.0,11.7){住所又は}
\put(4.0,11.15){ＴＥＬ}
\put(6.0,11.4){\用務先住所}


\put(3.8,8.4){\framebox(0.25,0.25){}}  %  公費
\put(3.8,5.8){\framebox(0.25,0.25){}}  %  私費



\put(4.6,10.3){ 経費区分 }
\put(4.5, 9.8){（財\phantom{源}源）}

\put(4.6,8.9){ 所\phantom{源源}轄 }
\put(4.6,8.4){\scriptsize 運営費交付金等}
\put(4.6,8.1){\scriptsize の場合のみ記入}
\put(4.65,8.3){\oval(0.3,0.9)[l]}
\put(6.4,8.3){\oval(0.3,0.9)[r]}

\put(4.6,7.3){ 目\phantom{源源}的 }
\put(4.6,6.8){\scriptsize 運営費交付金等}
\put(4.6,6.5){\scriptsize の場合のみ記入}
\put(4.65,6.7){\oval(0.3,0.9)[l]}
\put(6.4,6.7){\oval(0.3,0.9)[r]}


\put(7.0,10.6){\framebox(0.25,0.25){}\hspace{2.8mm}運営費交付金等}
\put(7.0,10.1){\framebox(0.25,0.25){}\hspace{2.8mm}委任経理金\phantom{金}（寄付金名称：\phantom{あれこれあれこ}）}
\put(7.0, 9.6){\framebox(0.25,0.25){}\hspace{2.8mm}科学研究費等（課題番号：\phantom{あれこれあれこれ}）}

\put(7.28,10.1){\phantom{\framebox(0.25,0.25){}委任経理金金（寄付金名称：}\寄付金名称}
\put(7.28, 9.6){\phantom{\framebox(0.25,0.25){}科学研究費等（課題番号：}\課題番号}





\put(7.0,9.0){\framebox(0.25,0.25){}\hspace{2.8mm}個人研究費\phantom{金}（\framebox(0.25,0.25){} 学部・修士予算\phantom{あ}\framebox(0.25,0.25){} 連大予算）}
\put(7.0,8.5){\framebox(0.25,0.25){}\hspace{2.8mm}講座共通費\phantom{金}（\phantom{寄付金名称：あれこれあれこ}）}
\put(7.0,8.0){\framebox(0.25,0.25){}\hspace{2.8mm}その他\phantom{金}（プロジェクト等：\phantom{あれあれこれれ}）}

\put(7.28,8.5){\phantom{\framebox(0.25,0.25){}講座共通費金（}\講座共通費名}
\put(7.28,8.0){\phantom{\framebox(0.25,0.25){}その他金（プロジェクト等：}\プロジェクト名}


\put(6.8,7.4){\footnotesize
（主\spm た\spm る\spm 目\spm 的\spm に\spm つ\spm い\spm て\spm 、\spm 
い\spm ず\spm れ\spm か\spm 一\spm 方\spm の\spm み\spm に\spm レ\spm 点\spm を\spm 
付\spm し\spm て\spm く\spm だ\spm さ\spm い\spm 。\spm ）}
\put(7.0,6.9){\framebox(0.25,0.25){}\hspace{2.8mm}教育経費（学生等に対する教育に要する経費）}
\put(7.0,6.4){\framebox(0.25,0.25){}\hspace{2.8mm}研究経費（研究に要する経費）}


\put(4.6,5.8){ 私\phantom{源源}費 }


\put(4.2,5.2){\scriptsize 連\spm 絡\spm 先\spm 名\spm 又\spm は\spm 住\spm 所}
\put(4.2,4.2){Ｔ\hspace{3mm}Ｅ\hspace{3mm}Ｌ}
\put(6.8,5.0){\連絡先名}
\put(6.8,4.2){\連絡先電話番号}


\put(4.2,3.4){\備考}












\put(0.7,1.4){決\phantom{Ｑ}裁\phantom{Ｑ}欄}


\put(3.95,1.9){庶\phantom{理}務}
\put(3.95,1.4){課\phantom{理}長}

\put(5.85,1.9){課\phantom{理}長}
\put(5.85,1.4){補\phantom{理}佐}

\put(7.5,1.9){勤\phantom{x}務\phantom{x}時\phantom{x}間}
\put(7.5,1.4){管\phantom{理}理\phantom{理}員}

\put(10.0,1.9){出勤簿登載}
\put(10.0,1.4){年\phantom{理}月\phantom{理}日}

\put(12.6,1.9){備\phantom{へ}考}
\put(13.9,1.4){\framebox(0.25,0.25){}\phantom{空}出\phantom{空}張}
\put(13.9,0.8){\framebox(0.25,0.25){}\phantom{空}研\phantom{空}修}

\put(10.0,0.8){平成\phantom{空空}年}
\put(10.0,0.2){\hspace{6mm}月\hspace{6.5mm}日}

\end{picture}
\end{figure} 
\end{document}








