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klhis/file/reporttemplate/34D5F563-F591-8D63-96E9-160.../住院收费电子发票打印/0b306883b3cb6be272b70b6bd04...

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<P align=center><SPAN id=A53773DA-E771-E8FD-87F8-5BD3CF7A9CE2 class=Emr_hdy align="center" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="COMPANYID" watid="A53773DA-E771-E8FD-87F8-5BD3CF7A9CE2">$COMPANYID$</SPAN><SPAN></SPAN><BR>
<P></P><SPAN></SPAN><STRONG><FONT style="FONT-SIZE: 3.15mm">                 住院收费单据</FONT></STRONG><BR>
<P></P>
<P></P>
<P>
<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>
<TBODY>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">姓名:<SPAN id=C0FAF31D-B45C-B43C-D385-D15C66D29296 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="XM" watid="C0FAF31D-B45C-B43C-D385-D15C66D29296">$XM$</SPAN></FONT></TD>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">性别:<SPAN id=AADC2BF4-BCA6-8D6B-CCEE-97C0EDC2239B class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="XB" watid="AADC2BF4-BCA6-8D6B-CCEE-97C0EDC2239B">$XB$</SPAN> 年龄:<SPAN id=0E8F6861-5C36-6FAB-CCF4-7E7A62FBAD9F class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="JZNL" watid="0E8F6861-5C36-6FAB-CCF4-7E7A62FBAD9F">$JZNL$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">住院号:<SPAN id=889D9F3F-8508-E98D-9D99-98BEDCFF1D96 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="ZYNO" watid="889D9F3F-8508-E98D-9D99-98BEDCFF1D96">$ZYNO$</SPAN><SPAN> 次数:<SPAN id=880DDAC1-1D1B-691E-6EDB-80FFCB9D05FC class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="ZYNUM" watid="880DDAC1-1D1B-691E-6EDB-80FFCB9D05FC">$ZYNUM$</SPAN></SPAN></FONT></TD>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">电话号码:<SPAN id=63409F18-022B-D614-1BE3-8774FBDA1866 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="PHONE" watid="63409F18-022B-D614-1BE3-8774FBDA1866">$PHONE$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">类别:<SPAN id=2640A350-B623-AC1D-5F93-AAB01777693D class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="结算类型" watid="2640A350-B623-AC1D-5F93-AAB01777693D">$结算类型$</SPAN></FONT></TD>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">就诊日期:<SPAN id=38E38D57-A9BC-F5C6-AAEA-1C372AF33164 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="JJRQ*yyyy-MM-dd" watid="38E38D57-A9BC-F5C6-AAEA-1C372AF33164">$JJRQ*yyyy-MM-dd$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=285 colSpan=2 class><FONT style="FONT-SIZE: 2.81mm">就诊科室:<SPAN id=F77ABC50-909D-87DB-CB99-2C5BB20720C2 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="JJKS" watid="F77ABC50-909D-87DB-CB99-2C5BB20720C2">$JJKS$</SPAN></FONT></TD></TR></TBODY></TABLE></P>
<P><FONT style="FONT-SIZE: 2.81mm">★此单据作为电子发票唯一凭证,请妥善保管！</FONT></P>
<P>
<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>
<TBODY>
<TR class>
<TD style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=121 align=center class><FONT style="FONT-SIZE: 2.81mm">费用类别名称</FONT></TD>
<TD style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=97 align=center class><FONT style="FONT-SIZE: 2.81mm">费用类别金额</FONT></TD></TR>
<P $data>
<TR class>
<TD style="CURSOR: default" height=23 width=121 class><SPAN id=C54C4168-8E28-EAC0-C89F-36414EFAB2D3 class=Emr_hdy style="FONT-SIZE: 2.81mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="FYLBMC" watid="C54C4168-8E28-EAC0-C89F-36414EFAB2D3">^FYLBMC^</SPAN><FONT style="FONT-SIZE: 2.81mm"></FONT></TD>
<TD style="CURSOR: default" height=23 width=97 class><SPAN id=342639F9-647F-3B45-E049-EA256A509809 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="FYLBJE" watid="342639F9-647F-3B45-E049-EA256A509809">^FYLBJE^</SPAN><FONT style="FONT-SIZE: 2.81mm"></FONT></TD></TR>
<P $data><FONT style="FONT-SIZE: 2.81mm"></FONT></P></TBODY></TABLE></P>
<P>
<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 bgColor=transparent border=1 class>
<TBODY>
<TR class>
<TD style="CURSOR: default" height=23 width=284 colSpan=2 class><FONT style="FONT-SIZE: 2.81mm">合计金额:<SPAN id=6ACB885E-E358-89E8-FC34-541F486D925B class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="医疗费总额" watid="6ACB885E-E358-89E8-FC34-541F486D925B">$医疗费总额$</SPAN> 优惠:</FONT></TD></TR>
<TR class>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">医保个账:<SPAN id=93F80888-C5F7-10A6-FB1A-DF78EC14B558 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="基本医疗保险统筹基金支出" watid="93F80888-C5F7-10A6-FB1A-DF78EC14B558">$基本医疗保险统筹基金支出$</SPAN></FONT></TD>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm"></FONT><FONT style="FONT-SIZE: 2.81mm">统筹支付:<SPAN id=079E01EB-B1F2-34A6-348E-DDF156B14233 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="个人账户支出" watid="079E01EB-B1F2-34A6-348E-DDF156B14233">$个人账户支出$</SPAN></FONT></TD></TR>
<TR class>
<TD style="CURSOR: default" height=23 width=284 colSpan=2 class><SPAN id=6B74CE8B-B72C-8A5D-B449-43B504E46764 class=Emr_hdy style="FONT-SIZE: 2.81mm" wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="个人资金支付方式显示" watid="6B74CE8B-B72C-8A5D-B449-43B504E46764">$个人资金支付方式显示$</SPAN><FONT style="FONT-SIZE: 2.81mm"></FONT></TD></TR>
<TR class>
<TD style="CURSOR: default" height=23 width=284 colSpan=2 class><FONT style="FONT-SIZE: 2.81mm">实收金额:<SPAN id=534941B9-6481-A08B-12D0-533DA2C3D7B2 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="个人现金支出" watid="534941B9-6481-A08B-12D0-533DA2C3D7B2">$个人现金支出$</SPAN></FONT></TD></TR>
<TR class>
<TD style="CURSOR: default" width=284 colSpan=2 class><FONT style="FONT-SIZE: 2.81mm">人民币(大写):<SPAN id=D6B8CBFD-7678-67BC-D9AD-93353489DEDC class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="个人支付额大写" watid="D6B8CBFD-7678-67BC-D9AD-93353489DEDC">$个人支付额大写$</SPAN></FONT></TD></TR></TBODY></TABLE></P>
<P>---------------<STRONG>电子发票</STRONG>-----------------</P>
<P><STRONG>温馨提示:</STRONG></P>
<P><FONT style="FONT-SIZE: 2.81mm">★电子票据和纸质票据同等法律效力，如需纸质票据，可前往票据打印窗口进行打印</FONT></P>
<P>
<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=1 class>
<TBODY>
<TR style="HEIGHT: 186px" class>
<TD style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=186 vAlign=middle width=286 align=center class></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class><FONT style="FONT-SIZE: 2.81mm">票据代码：<SPAN id=647D4C37-6DA1-8533-5130-80655B3C5FBA class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="D票据代码" watid="647D4C37-6DA1-8533-5130-80655B3C5FBA">$D票据代码$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class><FONT style="FONT-SIZE: 2.81mm">票据号码：<SPAN id=98E306A0-7413-96CA-0396-C4604E3AB499 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="D票据号码" watid="98E306A0-7413-96CA-0396-C4604E3AB499">$D票据号码$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class><FONT style="FONT-SIZE: 2.81mm">校验码：<SPAN id=CE3E8687-8E47-9727-C216-D6138E9EB250 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="D校验码" watid="CE3E8687-8E47-9727-C216-D6138E9EB250">$D校验码$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class><FONT style="FONT-SIZE: 2.81mm">缴费时间：<SPAN id=328FC07A-24FF-0E09-08E4-1349FE8D6DB3 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="D缴费时间" watid="328FC07A-24FF-0E09-08E4-1349FE8D6DB3">$D缴费时间$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class></TD></TR></TBODY></TABLE></P>
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