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<?xml version="1.0" encoding="UTF-8"?>
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<emr>
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<page styleline="false" height="127" width="210" lineheight="1.5" letterspace="0.0" paddingleft="0.0" paddingright="10.0" paddingtop="33.0" paddingbottom="10.0" portrait="1" />
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<headercontent>
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<![CDATA[
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]]>
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</headercontent>
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<content>
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<![CDATA[
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<P></P>
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<P></P>
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<P></P>
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<P style= images sydyrmyy 43.143.11.12:7888 http: dzfp.png?);background-repeat:no-repeat;background-position:center;background-size:cover;?>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BACKGROUND-IMAGE: url(http://43.143.11.12:7888/sydyrmyy/images/dzfp.png); BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" cellSpacing=0 cellPadding=0 width="81%" bgColor=transparent border=1 class>
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<TBODY></TBODY></TABLE>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=1 class>
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<TBODY></TBODY></TABLE>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=1 class>
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<TBODY>
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<TR style="HEIGHT: 23px" class>
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<TD style="CURSOR: default" height=23 width=277 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN> </SPAN><SPAN> </SPAN><SPAN> <FONT style="FONT-SIZE: 2.81mm"> </FONT></SPAN><SPAN id=C40276A0-7EF7-6ECD-EFD7-E2A80C36B0A5 class=Emr_hdy style="FONT-SIZE: 3.7mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="XM" watid="C40276A0-7EF7-6ECD-EFD7-E2A80C36B0A5"><FONT style="FONT-SIZE: 2.81mm">$XM$</FONT></SPAN></FONT></TD>
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<TD style="CURSOR: default" height=23 width=340 colSpan=2 class> <FONT style="FONT-SIZE: 2.81mm">(科室) <SPAN id=8D62D07E-6646-CBC1-6F98-2652CD946654 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="JJKS" watid="8D62D07E-6646-CBC1-6F98-2652CD946654">$JJKS$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=23 width=206 class>
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<P><FONT style="FONT-SIZE: 3.15mm"> </FONT><FONT style="FONT-SIZE: 3.15mm"><SPAN id=1E168821-282E-1869-ED4F-97F83A58B72B class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="CWJSSJ*yyyy年MM月dd日" watid="1E168821-282E-1869-ED4F-97F83A58B72B">$CWJSSJ*yyyy年MM月dd日$</SPAN> </FONT></P></TD></TR></TBODY></TABLE>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; TEXT-ALIGN: center; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 align=center bgColor=transparent border=1 class>
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<TBODY>
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<TR style="HEIGHT: 25px" class>
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<TD style="CURSOR: default" height=25 width=188 class><FONT style="FONT-SIZE: 3.15mm"><SPAN><SPAN id=BC63FEBF-36BA-813A-F868-48CCB5A4043C class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别1" watid="BC63FEBF-36BA-813A-F868-48CCB5A4043C">$费用类别1$</SPAN><SPAN> </SPAN><SPAN id=0ED084A4-BC94-41EF-DC9A-40D446EC8811 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额1" watid="0ED084A4-BC94-41EF-DC9A-40D446EC8811">$金额1$</SPAN><SPAN> </SPAN></SPAN></FONT></TD>
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<TD style="CURSOR: default" height=25 width=151 class><FONT style="FONT-SIZE: 3.15mm"><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=FF677790-C65C-E96C-182E-7364824C21E0 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别2" watid="FF677790-C65C-E96C-182E-7364824C21E0">$费用类别2$</SPAN><SPAN> </SPAN><SPAN id=C2143504-1D64-071C-59D1-6622A1C8CD81 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额2" watid="C2143504-1D64-071C-59D1-6622A1C8CD81">$金额2$</SPAN></FONT></FONT></TD>
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<TD style="CURSOR: default" height=25 width=146 class><FONT style="FONT-SIZE: 3.15mm"><SPAN id=8DD7AB5C-62C5-E0FB-F5EE-770F0F5734AB class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别3" watid="8DD7AB5C-62C5-E0FB-F5EE-770F0F5734AB">$费用类别3$</SPAN><SPAN> </SPAN><SPAN id=AD1B3B0D-3F0C-C0F6-7CD2-C3A266344368 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额3" watid="AD1B3B0D-3F0C-C0F6-7CD2-C3A266344368">$金额3$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=25 width=233 class><FONT style="FONT-SIZE: 3.7mm"><FONT style="FONT-SIZE: 3.15mm"><SPAN id=EE1C771B-3C35-247B-D694-23E09CEE45A5 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别4" watid="EE1C771B-3C35-247B-D694-23E09CEE45A5">$费用类别4$</SPAN><SPAN> <SPAN id=4929D9C1-CF39-3E4B-6FD6-0E07430F2A35 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额4" watid="4929D9C1-CF39-3E4B-6FD6-0E07430F2A35">$金额4$</SPAN></SPAN></FONT></FONT></TD></TR>
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<TR style="HEIGHT: 27px" class>
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<TD style="CURSOR: default" height=27 width=188 class><FONT style="FONT-SIZE: 3.15mm"><SPAN id=711D90C1-470D-B61D-330B-19200BC74B00 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别5" watid="711D90C1-470D-B61D-330B-19200BC74B00">$费用类别5$</SPAN><SPAN> </SPAN><SPAN id=56E32E22-2163-5292-CF84-D750AEF44C7C class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额5" watid="56E32E22-2163-5292-CF84-D750AEF44C7C">$金额5$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=27 width=151 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=4395897F-3410-B514-E679-1E327A4F876A class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别6" watid="4395897F-3410-B514-E679-1E327A4F876A">$费用类别6$</SPAN> <SPAN id=D5540017-D6BF-6419-3A51-D994F5F43161 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额6" watid="D5540017-D6BF-6419-3A51-D994F5F43161">$金额6$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=27 width=146 class><FONT style="FONT-SIZE: 3.15mm"><SPAN id=F7059459-2900-B7A1-D225-592D51068A99 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别7" watid="F7059459-2900-B7A1-D225-592D51068A99">$费用类别7$</SPAN> <SPAN id=A4EA9541-4283-9562-A28B-7275D8901612 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额7" watid="A4EA9541-4283-9562-A28B-7275D8901612">$金额7$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=27 width=233 class><FONT style="FONT-SIZE: 3.15mm"><SPAN id=AE024973-92BA-5AF1-5134-74F2D56CF09F class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别8" watid="AE024973-92BA-5AF1-5134-74F2D56CF09F">$费用类别8$</SPAN> <SPAN id=CE5368C1-A774-F6EB-9215-EC9E51EED339 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额8" watid="CE5368C1-A774-F6EB-9215-EC9E51EED339">$金额8$</SPAN></FONT></TD></TR>
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<TR style="HEIGHT: 24px" class>
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<TD style="CURSOR: default" height=24 width=188 class><SPAN><SPAN id=A8C1888A-2183-3700-E906-DE355E5DAEC9 class=Emr_hdy style="FONT-SIZE: 3.15mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别9" watid="A8C1888A-2183-3700-E906-DE355E5DAEC9">$费用类别9$</SPAN><SPAN> </SPAN><FONT style="FONT-SIZE: 2.45mm"><SPAN id=8054667D-C4C4-AC7A-2006-B6C0D97B63BC class=Emr_hdy style="FONT-SIZE: 3.15mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额9" watid="8054667D-C4C4-AC7A-2006-B6C0D97B63BC">$金额9$</SPAN></FONT></SPAN></TD>
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<TD style="CURSOR: default" height=24 width=151 class><FONT style="FONT-SIZE: 3.15mm"><SPAN> </SPAN><SPAN id=B2662849-132D-8C00-033B-320F850D63BD class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别10" watid="B2662849-132D-8C00-033B-320F850D63BD">$费用类别10$</SPAN><SPAN style="FONT-SIZE: 3.15mm"> <SPAN id=E5D60554-1786-CD45-D5B0-C00E02E77130 class=Emr_hdy style="FONT-SIZE: 3.15mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额10" watid="E5D60554-1786-CD45-D5B0-C00E02E77130">$金额10$</SPAN></SPAN></FONT></TD>
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<TD style="CURSOR: default" height=24 width=146 class><FONT style="FONT-SIZE: 3.15mm"><SPAN style="FONT-SIZE: 3.15mm"><SPAN id=CCF695D9-309C-38B4-2ADE-5D34BB93C774 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别11" watid="CCF695D9-309C-38B4-2ADE-5D34BB93C774">$费用类别11$</SPAN> <SPAN id=657634E5-61C8-49A9-6AB0-55A1DCCC21F1 class=Emr_hdy style="FONT-SIZE: 3.15mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额11" watid="657634E5-61C8-49A9-6AB0-55A1DCCC21F1">$金额11$</SPAN></SPAN></FONT></TD>
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<TD style="CURSOR: default" height=24 width=233 class><SPAN id=50F40F5D-DBA6-5DDE-CBA4-BB3FBDA41E13 class=Emr_hdy style="FONT-SIZE: 3.15mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别12" watid="50F40F5D-DBA6-5DDE-CBA4-BB3FBDA41E13">$费用类别12$</SPAN><SPAN> </SPAN><SPAN id=5F51CFD0-CA4F-1600-C0E2-0876DD65C5AF class=Emr_hdy style="FONT-SIZE: 3.15mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额12" watid="5F51CFD0-CA4F-1600-C0E2-0876DD65C5AF">$金额12$</SPAN><FONT style="FONT-SIZE: 3.15mm"></FONT></TD></TR>
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<TR style="HEIGHT: 24px" class>
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<TD style="CURSOR: default" height=24 width=188 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=A5C13E72-CD82-3004-56CE-CC2EB7A49B7E class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别13" watid="A5C13E72-CD82-3004-56CE-CC2EB7A49B7E">$费用类别13$</SPAN> <SPAN id=E459596C-167B-2746-6D2B-DD2BE4BEE2A6 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额13" watid="E459596C-167B-2746-6D2B-DD2BE4BEE2A6">$金额13$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=24 width=151 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=A3AB80F8-2F2E-CE00-1912-FA7E0899F24E class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别14" watid="A3AB80F8-2F2E-CE00-1912-FA7E0899F24E">$费用类别14$</SPAN> <SPAN id=50854DCB-8D6C-58A4-95CE-73C736832761 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额14" watid="50854DCB-8D6C-58A4-95CE-73C736832761">$金额14$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=24 width=146 class><FONT style="FONT-SIZE: 3.15mm"><SPAN id=A943EFF2-D4DC-6F80-6679-BF9D28182FFB class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别15" watid="A943EFF2-D4DC-6F80-6679-BF9D28182FFB">$费用类别15$</SPAN> <SPAN id=7752E915-4EC2-9C30-7816-AA76551300F1 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额15" watid="7752E915-4EC2-9C30-7816-AA76551300F1">$金额15$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=24 width=233 class><FONT style="FONT-SIZE: 3.15mm"><SPAN id=13E67A0F-C464-9A12-A3BE-26C7EE4C23D3 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别16" watid="13E67A0F-C464-9A12-A3BE-26C7EE4C23D3">$费用类别16$</SPAN><SPAN> <SPAN id=7B743FC8-9185-E515-01C4-D532B83F7178 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额16" watid="7B743FC8-9185-E515-01C4-D532B83F7178">$金额16$</SPAN></SPAN></FONT></TD></TR>
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<TR style="HEIGHT: 24px" class>
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<TD style="CURSOR: default" height=24 width=188 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=7DB97A16-9D2F-D369-F2E0-D68491EAD7F4 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别17" watid="7DB97A16-9D2F-D369-F2E0-D68491EAD7F4">$费用类别17$</SPAN> <SPAN id=EFA75E9B-DCE8-21EF-B3E5-852D08F4D709 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额17" watid="EFA75E9B-DCE8-21EF-B3E5-852D08F4D709">$金额17$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=24 width=151 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=EB024BF1-EC72-E82E-9C5C-682AE8198B06 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="费用类别18" watid="EB024BF1-EC72-E82E-9C5C-682AE8198B06">$费用类别18$</SPAN> <SPAN id=C2E16596-A3FF-28C3-4B9D-92218F61ED57 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="金额18" watid="C2E16596-A3FF-28C3-4B9D-92218F61ED57">$金额18$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=24 width=146 class> </TD>
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<TD style="CURSOR: default" height=24 width=233 class></TD></TR></TBODY></TABLE>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=1 class>
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<TBODY>
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<TR style="HEIGHT: 23px" class>
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<TD style="CURSOR: default" height=23 width=368 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=5DC6A018-8F70-4997-EB81-C7D08C686DF1 class=Emr_hdy style="FONT-SIZE: 3.15mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="医疗费总额大写" watid="5DC6A018-8F70-4997-EB81-C7D08C686DF1">$医疗费总额大写$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=23 width=387 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=9E42F34D-5C9A-E9C2-A75D-5ADBB0E1A2F6 class=Emr_hdy wattype="static" watflag='10"true"' watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="医疗费总额" watid="9E42F34D-5C9A-E9C2-A75D-5ADBB0E1A2F6">$医疗费总额$</SPAN></FONT></TD></TR></TBODY></TABLE>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="83%" bgColor=transparent border=1 class>
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<TBODY>
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<TR style="HEIGHT: 23px" class>
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<TD style="CURSOR: default" height=23 width=207 class><SPAN> </SPAN><SPAN id=984D776F-75BE-E3F9-F36E-B08CF9032F7A class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="流水号" watid="984D776F-75BE-E3F9-F36E-B08CF9032F7A">$流水号$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=207 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN> </SPAN><SPAN id=BFB63E8C-D45C-B18C-C4B7-76A751ED9108 class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="ZYNO" watid="BFB63E8C-D45C-B18C-C4B7-76A751ED9108">$ZYNO$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=23 width=209 class><FONT style="FONT-SIZE: 3.15mm"> </FONT></TD></TR></TBODY></TABLE>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="83%" bgColor=transparent border=1 class>
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<TBODY>
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<TR style="HEIGHT: 23px" class>
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<TD style="CURSOR: default" height=23 width=207 class><SPAN> </SPAN></TD>
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<TD style="CURSOR: default" height=23 width=205 class><SPAN> <FONT style="FONT-SIZE: 2.45mm"> <SPAN id=E91DA572-BA6B-7E75-6D74-AB6B89B6BD9F class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="HZYBLX" watid="E91DA572-BA6B-7E75-6D74-AB6B89B6BD9F">$HZYBLX$</SPAN></FONT></SPAN></TD>
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<TD style="CURSOR: default" height=23 width=210 class><SPAN> </SPAN><SPAN id=C264D02C-9DF8-DF94-7A23-0414217D38F4 class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="基金支付总额" watid="C264D02C-9DF8-DF94-7A23-0414217D38F4">$基金支付总额$</SPAN><FONT style="FONT-SIZE: 3.15mm"></FONT></TD></TR>
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<TR style="HEIGHT: 23px" class>
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<TD style="CURSOR: default" height=23 width=207 class> <SPAN> </SPAN><SPAN id=5BAED922-548B-40B1-69EB-A59980255FEC class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="居民大病保险资金支出" watid="5BAED922-548B-40B1-69EB-A59980255FEC">$居民大病保险资金支出$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=205 class><SPAN> </SPAN><SPAN id=1D3D9847-10E0-4EB7-7674-1ABBA81D6A66 class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="其他支出" watid="1D3D9847-10E0-4EB7-7674-1ABBA81D6A66">$其他支出$</SPAN><SPAN> </SPAN></TD>
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<TD style="CURSOR: default" height=23 width=210 class><SPAN> </SPAN><SPAN id=DAA2A835-1714-8FD5-D2FD-E3DA66EED4DB class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="结算日期*yyyy年MM月dd日" watid="DAA2A835-1714-8FD5-D2FD-E3DA66EED4DB">$结算日期*yyyy年MM月dd日$</SPAN></TD></TR>
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<TR style="HEIGHT: 23px" class>
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<TD style="CURSOR: default" height=23 class> <SPAN id=CC01CA89-867C-D0DA-914F-FFDEDB71AA0D class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="个人现金支出" watid="CC01CA89-867C-D0DA-914F-FFDEDB71AA0D">$个人现金支出$</SPAN></TD>
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<TD style="CURSOR: default" height=23 class><SPAN> </SPAN><SPAN id=C784C3AA-A221-EA2D-4708-E068AE555B79 class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="个人账户支出" watid="C784C3AA-A221-EA2D-4708-E068AE555B79">$个人账户支出$</SPAN><SPAN> </SPAN></TD>
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<TD style="CURSOR: default" height=23 class><SPAN> <SPAN id=5EF50B11-D411-3FA0-AA41-5BFF401533A0 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="XB" watid="5EF50B11-D411-3FA0-AA41-5BFF401533A0">$XB$</SPAN></SPAN></TD></TR>
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<TR style="HEIGHT: 23px" class>
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<TD style="CURSOR: default" height=23 class> <SPAN id=5D62CBDE-18EC-DD5D-766B-CEE6880B08C2 class=Emr_hdy style="FONT-SIZE: 10px" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="医疗救助基金支出" watid="5D62CBDE-18EC-DD5D-766B-CEE6880B08C2">$医疗救助基金支出$</SPAN></TD>
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<TD style="CURSOR: default" height=23 class></TD>
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<TD style="CURSOR: default" height=23 class></TD></TR></TBODY></TABLE>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=1 class>
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<TBODY>
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<TR style="HEIGHT: 23px" class>
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<TD style="CURSOR: default" height=23 width=357 class><FONT style="FONT-SIZE: 3.15mm"> <SPAN id=4BBE1356-43A5-0DCF-88D3-79721AA67CBC class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="COMPANYID" watid="4BBE1356-43A5-0DCF-88D3-79721AA67CBC">$COMPANYID$</SPAN></FONT></TD>
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<TD style="CURSOR: default" height=23 width=78 class><SPAN id=575160A5-AA61-FAAE-4FE4-D2B9E7EC14C9 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="复核人" watid="575160A5-AA61-FAAE-4FE4-D2B9E7EC14C9"><FONT style="FONT-SIZE: 3.15mm">$复核人$</FONT></SPAN></TD>
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<TD style="CURSOR: default" height=23 width=319 class><FONT style="FONT-SIZE: 3.15mm"><SPAN id=DE149B82-579A-0B9C-D843-D336F1A884A9 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="收款人" watid="DE149B82-579A-0B9C-D843-D336F1A884A9">$收款人$</SPAN></FONT></TD></TR></TBODY></TABLE></P>
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<P></P>
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]]>
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</content>
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<footercontent>
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<![CDATA[
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</footercontent>
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</emr>
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