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klhis/file/reporttemplate/DE3C9D58-C91A-459E-74D0-589.../住院证打印/892860e560b287117b54bdda920...

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3 months ago
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<P align=center><SPAN> </SPAN><SPAN id=898B6C7C-162A-359B-DAD0-2B29469EDCC7 class=Emr_hdy align="center" wattype="static" watid="898B6C7C-162A-359B-DAD0-2B29469EDCC7" watvalue="COMPANYID" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$COMPANYID$</SPAN><SPAN></SPAN><BR></P>
<P align=center>住 院 证</P>
<P align=left>
<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>
<TBODY>
<TR>
<TD style="CURSOR: default"></TD>
<TD style="CURSOR: default"></TD>
<TD style="CURSOR: default" width=358 colSpan=2>住院证号:<SPAN id=2015B19B-5532-7D59-5A25-1DF0458F08D3 class=Emr_hdy wattype="static" watid="2015B19B-5532-7D59-5A25-1DF0458F08D3" watvalue="ZYZH" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$ZYZH$</SPAN></TD></TR>
<TR style="HEIGHT: 23px">
<TD style="CURSOR: default" height=23 width=179>姓名:<SPAN id=43317356-7A5F-A72C-96C7-628366C7A179 class=Emr_hdy wattype="static" watid="43317356-7A5F-A72C-96C7-628366C7A179" watvalue="XM" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XM$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=179>性别:<SPAN id=014C541B-6861-07F8-F001-D740E73640FA class=Emr_hdy wattype="static" watid="014C541B-6861-07F8-F001-D740E73640FA" watvalue="XB" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XB$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=179>出生日期:<SPAN id=10DD89C9-BA92-3DCE-D7E0-605C32ED5CBD class=Emr_hdy wattype="static" watid="10DD89C9-BA92-3DCE-D7E0-605C32ED5CBD" watvalue="CSRQ*yyyy年MM月dd日" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$CSRQ*yyyy年MM月dd日$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=179>年龄:<SPAN id=25958DA6-A72E-2754-CBA1-D025E4B46BEF class=Emr_hdy wattype="static" watid="25958DA6-A72E-2754-CBA1-D025E4B46BEF" watvalue="NL" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$NL$</SPAN></TD></TR>
<TR style="HEIGHT: 23px">
<TD style="CURSOR: default" height=23 width=179>婚姻:<SPAN id=5BB0F130-7C5D-2841-A023-4457EA8CD93D class=Emr_hdy wattype="static" watid="5BB0F130-7C5D-2841-A023-4457EA8CD93D" watvalue="HYZK" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$HYZK$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=538 colSpan=3>出生地:<SPAN id=18669592-43C4-97C9-1C50-7502BB9B183E class=Emr_hdy wattype="static" watid="18669592-43C4-97C9-1C50-7502BB9B183E" watvalue="CSDZ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$CSDZ$</SPAN></TD></TR>
<TR style="HEIGHT: 23px">
<TD style="CURSOR: default" height=23 width=358 colSpan=2>职业:<SPAN id=2B30BCEE-026E-1E88-7B82-575126BFE8BD class=Emr_hdy wattype="static" watid="2B30BCEE-026E-1E88-7B82-575126BFE8BD" watvalue="ZY" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$ZY$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=179>民族:<SPAN id=B751C56C-8349-BD2E-5ECE-1A597C3F5122 class=Emr_hdy wattype="static" watid="B751C56C-8349-BD2E-5ECE-1A597C3F5122" watvalue="MZ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$MZ$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=179>国籍:<SPAN id=72B7BCDB-CD1F-A2E7-B3C6-78B562FF8FB7 class=Emr_hdy wattype="static" watid="72B7BCDB-CD1F-A2E7-B3C6-78B562FF8FB7" watvalue="GJ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$GJ$</SPAN></TD></TR>
<TR style="HEIGHT: 23px">
<TD style="CURSOR: default" height=23 width=358 colSpan=2>身份证:<SPAN id=3DD2A635-BD53-3B21-D2C4-FC627F0C4A93 class=Emr_hdy wattype="static" watid="3DD2A635-BD53-3B21-D2C4-FC627F0C4A93" watvalue="SFZH" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$SFZH$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=358 colSpan=2>工作单位:<SPAN id=3FAAA54C-E38B-BAAD-C6A2-AEA16BDB9C0F class=Emr_hdy wattype="static" watid="3FAAA54C-E38B-BAAD-C6A2-AEA16BDB9C0F" watvalue="GZDW" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$GZDW$</SPAN></TD></TR>
<TR style="HEIGHT: 23px">
<TD style="CURSOR: default" height=23 width=537 colSpan=3>地址:<SPAN id=1311899E-FC6D-D900-3B0F-09232D077DE0 class=Emr_hdy wattype="static" watid="1311899E-FC6D-D900-3B0F-09232D077DE0" watvalue="XZDZ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XZDZ$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=179>电话:<SPAN id=1D1B9F51-18DF-8DFA-1283-53F79D6EDD82 class=Emr_hdy wattype="static" watid="1D1B9F51-18DF-8DFA-1283-53F79D6EDD82" watvalue="PHONE" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$PHONE$</SPAN></TD></TR>
<TR style="HEIGHT: 23px">
<TD style="CURSOR: default" height=23 width=358 colSpan=2>联系人:<SPAN id=17BE3386-3357-86D1-80A2-737830A77E76 class=Emr_hdy wattype="static" watid="17BE3386-3357-86D1-80A2-737830A77E76" watvalue="LXR" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$LXR$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=358 colSpan=2>联系人电话:<SPAN id=8AE21126-4604-AA10-0076-E0E761886ADC class=Emr_hdy wattype="static" watid="8AE21126-4604-AA10-0076-E0E761886ADC" watvalue="LXRDH" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$LXRDH$</SPAN></TD></TR>
<TR style="HEIGHT: 23px">
<TD style="CURSOR: default" height=23 width=358 colSpan=2>入院科室:<SPAN id=AE93AC90-6F2C-33EC-3576-D2AF6C3652F8 class=Emr_hdy wattype="static" watid="AE93AC90-6F2C-33EC-3576-D2AF6C3652F8" watvalue="ZYKS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$ZYKS$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=358 colSpan=2>门诊诊断:<SPAN id=AECE62F5-9F0D-695B-EC9D-E0AB207DFDBE class=Emr_hdy wattype="static" watid="AECE62F5-9F0D-695B-EC9D-E0AB207DFDBE" watvalue="LCZD" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$LCZD$</SPAN></TD></TR>
<TR style="HEIGHT: 23px">
<TD style="CURSOR: default" height=23 width=537 colSpan=3>病情:<SPAN id=F658C8E9-5C63-F557-5D02-218E6E1DDAA6 class=Emr_hdy wattype="static" watid="F658C8E9-5C63-F557-5D02-218E6E1DDAA6" watvalue="RYBQ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$RYBQ$</SPAN><SPAN>              费别:<SPAN id=20D4B085-376F-6501-FA66-FB6F1A92928B class=Emr_hdy wattype="static" watid="20D4B085-376F-6501-FA66-FB6F1A92928B" watvalue="HZLX" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$HZLX$</SPAN></SPAN></TD>
<TD style="CURSOR: default" height=23 width=179>预交金:<SPAN id=6E3338AB-ABE3-A76D-043C-F6D1B2CD4237 class=Emr_hdy wattype="static" watid="6E3338AB-ABE3-A76D-043C-F6D1B2CD4237" watvalue="ZYJY" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$ZYJY$</SPAN></TD></TR>
<TR>
<TD style="CURSOR: default" width=358 colSpan=2>以上信息由患者本人(或委托人)核对无误！</TD>
<TD style="CURSOR: default" width=358 colSpan=2>签证医师:<SPAN id=0B5ABD72-488E-7DE6-55D7-4B563A094745 class=Emr_hdy wattype="static" watid="0B5ABD72-488E-7DE6-55D7-4B563A094745" watvalue="JJYS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJYS$</SPAN></TD></TR>
<TR>
<TD style="CURSOR: default" width=716 colSpan=4>患者(委托人)签字                 住院号(住院登记处填写）                 签证日期:<SPAN id=9ACF7726-6E62-B640-CDFA-FB3D98DAD38F class=Emr_hdy wattype="static" watid="9ACF7726-6E62-B640-CDFA-FB3D98DAD38F" watvalue="BUILDDATE*yyyy-MM-dd" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$BUILDDATE*yyyy-MM-dd$</SPAN></TD></TR></TBODY></TABLE></P>
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