Abbreviation of 政令指定都市 (せいれいしていとし). Refers to a city designated by government ordinance under Japan's Local Autonomy Law, with greater administrative authority than ordinary cities.
See also: 政令指定都市
Osaka City is one of the ordinance-designated cities.
city designated to operate its own public health centers
Abbreviation of 政令指定都市 (せいれいしていとし), literally 'government-ordinance-designated city'.