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<?xml version="1.0" encoding="UTF-8"?>
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<emr>
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<page styleline="false" height="210" width="148" lineheight="1.3" letterspace="0.0" paddingleft="19.0" paddingright="19.0" paddingtop="11.0" paddingbottom="15.0" 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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<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 bgColor=transparent border=0>
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<TBODY>
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<TR class=Emr_table_dotted style="HEIGHT: 53px" class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=53 vAlign=middle rowSpan=2 width=342 align=center class="Emr_table_dotted">
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<P> <SPAN id=38A9740A-0182-B963-2FA0-CF7D53A0EDC0 class=Emr_hdy style="FONT-SIZE: 4.93mm" wattype="static" watid="38A9740A-0182-B963-2FA0-CF7D53A0EDC0" watvalue="JGID" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JGID$</SPAN><STRONG><FONT style="FONT-SIZE: 5.55mm">处方笺</FONT></STRONG></FONT></P></TD>
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP: #000000 1px solid; BORDER-RIGHT: #000000 1px solid; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT: #000000 1px solid" height=53 vAlign=middle width=56 align=center class="Emr_table_dotted">
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<P><STRONG><FONT style="FONT-SIZE: 4.93mm">普通</FONT></STRONG></P>
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<P><STRONG><FONT style="FONT-SIZE: 4.93mm">处方</FONT></STRONG></P></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=53 width=8 class="Emr_table_dotted"> </TD></TR></TBODY></TABLE>
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<P>
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<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 101%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#000000 cellSpacing=0 cellPadding=0 width="101%" bgColor=transparent border=0>
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<TBODY>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP: #000000 1px solid; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT-COLOR: ; BORDER-RIGHT-COLOR: " height=23 vAlign=top width=201 class="Emr_table_dotted">编号:<SPAN id=4078FAB4-5B31-E830-4409-D1B9C3A6C518 class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="4078FAB4-5B31-E830-4409-D1B9C3A6C518" watvalue="处方号" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$处方号$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP: #000000 1px solid; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=215 class="Emr_table_dotted">处方开具日期:<SPAN id=23ACACA4-D8BC-BDED-F654-ACA6B5D064B5 class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="23ACACA4-D8BC-BDED-F654-ACA6B5D064B5" watvalue="JJRQ*yyyy年MM月dd日" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJRQ*yyyy年MM月dd日$</SPAN></TD></TR></TBODY></TABLE></P>
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<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 bgColor=transparent border=1 class>
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<TBODY></TBODY></TABLE>
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<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 98%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="98%" bgColor=transparent border=0>
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<TBODY>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=240 colSpan=2 class="Emr_table_dotted">患者姓名:<SPAN id=6B64A805-5713-3A9B-A323-83BC6DC0A70E class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="6B64A805-5713-3A9B-A323-83BC6DC0A70E" watvalue="XM" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XM$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=77 class="Emr_table_dotted">性别:<SPAN id=8C4E733D-3103-307F-C3E0-2E15F0E3C30F class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="8C4E733D-3103-307F-C3E0-2E15F0E3C30F" watvalue="XB" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XB$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=85 class="Emr_table_dotted">年龄:<SPAN id=5CF2FB28-8CE9-F5B2-7DAF-05CEF9687962 class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="5CF2FB28-8CE9-F5B2-7DAF-05CEF9687962" watvalue="NL" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$NL$</SPAN></TD></TR>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP: #ffffff 1px solid; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=240 colSpan=2 class="Emr_table_dotted">身份证号:<SPAN id=F95AC7F4-C23C-343D-81E5-A57318B25EEF class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="F95AC7F4-C23C-343D-81E5-A57318B25EEF" watvalue="SFZH" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$SFZH$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=163 colSpan=2 class="Emr_table_dotted">族别:<SPAN id=D65A140D-2F07-DD16-D79C-84F7EE447F4E class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="D65A140D-2F07-DD16-D79C-84F7EE447F4E" watvalue="MZ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$MZ$</SPAN></TD></TR></TBODY></TABLE>
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<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 bgColor=transparent border=0>
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<TBODY>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=391 class="Emr_table_dotted">门诊号/病案号:<SPAN id=68769495-EBCD-8EC5-F60F-83B6F5A8D2F2 class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="68769495-EBCD-8EC5-F60F-83B6F5A8D2F2" watvalue="MZNO" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$MZNO$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=32 class="Emr_table_dotted"></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=214 class="Emr_table_dotted"><SPAN contentEditable=false style="HEIGHT: 3px; WIDTH: 9px"><FONT face=System><INPUT type=checkbox> </FONT></SPAN><FONT face=System> </FONT><FONT style="FONT-SIZE: 3.7mm">职工医保</FONT></TD></TR>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=391 class="Emr_table_dotted">科别:<SPAN id=D730E877-1D40-86C2-47A8-7A484182DB3F class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="D730E877-1D40-86C2-47A8-7A484182DB3F" watvalue="JJKS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJKS$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=32 class="Emr_table_dotted">
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<P><FONT style="FONT-SIZE: 3.15mm">费</FONT></P>
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<P><FONT style="FONT-SIZE: 3.15mm">别</FONT></P></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=214 class="Emr_table_dotted"><SPAN contentEditable=false style="HEIGHT: 3px; WIDTH: 9px"><INPUT type=checkbox> </SPAN> 城乡医保</TD></TR>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=391 class="Emr_table_dotted">代办人姓名:</TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=32 class="Emr_table_dotted"></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=214 class="Emr_table_dotted"><SPAN contentEditable=false style="HEIGHT: 3px; WIDTH: 9px"><INPUT type=checkbox> </SPAN> 自费</TD></TR>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default" width=391 class="Emr_table_dotted">代办人身份证:</TD>
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<TD class=Emr_table_dotted style="CURSOR: default" width=32 class="Emr_table_dotted"></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" class="Emr_table_dotted"></TD></TR></TBODY></TABLE>
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<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 101%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="101%" bgColor=transparent border=0>
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<TBODY>
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<TR class=Emr_table_dotted style="HEIGHT: 23px" class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP: #000000 1px solid; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=287 class="Emr_table_dotted">临床诊断:<SPAN id=6EF847E0-F7D5-295C-3D9D-28CEE4316E69 class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="6EF847E0-F7D5-295C-3D9D-28CEE4316E69" watvalue="疾病" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$疾病$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP: #000000 1px solid; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=123 class="Emr_table_dotted">处方顺序号:</TD></TR></TBODY></TABLE>
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<P><STRONG><FONT style="FONT-SIZE: 3.7mm">Rp:</FONT></STRONG></P>
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<P>
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<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 bgColor=transparent border=0>
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<TBODY>
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<P $data>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default" width=15 class="Emr_table_dotted"> </TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=197 class="Emr_table_dotted"><SPAN id=D8AF09E4-F765-1A80-3A13-B8F9F48F36D8 class=Emr_hdy wattype="static" watid="D8AF09E4-F765-1A80-3A13-B8F9F48F36D8" watvalue="药品" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^药品^</SPAN><SPAN> </SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=113 class="Emr_table_dotted"><SPAN id=5B28A7FD-EBBC-B2F0-6010-836AD88FACBE class=Emr_hdy wattype="static" watid="5B28A7FD-EBBC-B2F0-6010-836AD88FACBE" watvalue="规格" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^规格^</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=83 class="Emr_table_dotted"><SPAN> </SPAN><SPAN id=FBA7EE20-88C8-85C5-92F1-6A7CF49B139C class=Emr_hdy wattype="static" watid="FBA7EE20-88C8-85C5-92F1-6A7CF49B139C" watvalue="数量" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^数量^</SPAN><SPAN id=20EE381F-F8F0-CD20-0813-74CC3161411A class=Emr_hdy wattype="static" watid="20EE381F-F8F0-CD20-0813-74CC3161411A" watvalue="单位" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^单位^</SPAN></TD></TR>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default" width=15 class="Emr_table_dotted"> </TD>
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=197 align=right class="Emr_table_dotted"><SPAN id=BA0E5D57-13F1-34F6-4FB3-9929ABCA40C6 class=Emr_hdy wattype="static" watid="BA0E5D57-13F1-34F6-4FB3-9929ABCA40C6" watvalue="剂量" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^剂量^</SPAN><SPAN id=6BAC53EE-2F54-E5E6-D269-96070D302664 class=Emr_hdy wattype="static" watid="6BAC53EE-2F54-E5E6-D269-96070D302664" watvalue="剂量单位" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^剂量单位^</SPAN><SPAN></SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=113 align=right class="Emr_table_dotted"><SPAN id=0F74C236-A756-DFDA-5AA4-439F9255F99F class=Emr_hdy wattype="static" watid="0F74C236-A756-DFDA-5AA4-439F9255F99F" watvalue="用法" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^用法^</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=83 align=right class="Emr_table_dotted"><SPAN id=E6538C2A-67EB-2CB2-5062-DF749E5A994A class=Emr_hdy wattype="static" watid="E6538C2A-67EB-2CB2-5062-DF749E5A994A" watvalue="频次" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^频次^</SPAN><SPAN> </SPAN></TD></TR>
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<P $data></P></TBODY></TABLE></P>
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<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=0>
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<TBODY>
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<TR class=Emr_table_dotted style="HEIGHT: 23px" class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP: #000000 1px solid; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=321 class="Emr_table_dotted">医师:<SPAN id=C35C1E7F-8491-F436-3B6F-E8DFA4D60F0A class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="C35C1E7F-8491-F436-3B6F-E8DFA4D60F0A" watvalue="JJYS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJYS$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default; BORDER-TOP: #000000 1px solid; BORDER-BOTTOM: #000000 1px solid; BORDER-LEFT-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=321 class="Emr_table_dotted"></TD></TR></TBODY></TABLE>
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<P></P>
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<P>
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<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.3" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=0>
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<TBODY>
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<TR class=Emr_table_dotted class="Emr_table_dotted">
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=113 class="Emr_table_dotted">药品金额:<SPAN id=F2ABFB55-408C-0204-D8D3-4A1483CE3846 class=Emr_hdy style="FONT-FAMILY: 宋体" wattype="static" watid="F2ABFB55-408C-0204-D8D3-4A1483CE3846" watvalue="总金额" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$总金额$</SPAN></TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=85 class="Emr_table_dotted">审核:</TD>
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<TD class=Emr_table_dotted style="CURSOR: default" width=77 class="Emr_table_dotted">调配:</TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=63 class="Emr_table_dotted">核对:</TD>
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<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=70 class="Emr_table_dotted">发药:</TD></TR></TBODY></TABLE></P>
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<P><FONT style="FONT-SIZE: 3.7mm">注:此处方只限在本医疗机构使用。处方顺序号由医师负责填写。</FONT></P>
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]]>
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</content>
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<footercontent>
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]]>
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</footercontent>
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</emr>
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