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klhis/file/reporttemplate/DE3C9D58-C91A-459E-74D0-589.../门诊收费电子发票打印/af9aa99583f58c6b23ea647d4d5...

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<P align=center><SPAN id=182AFC85-1B8E-4B3D-0336-0CB233525F8D class=Emr_hdy wattype="static" watid="182AFC85-1B8E-4B3D-0336-0CB233525F8D" watvalue="JGID" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JGID$</SPAN>
<P></P><SPAN></SPAN><STRONG><FONT style="FONT-SIZE: 3.15mm">门诊收费单据</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" watid="C0FAF31D-B45C-B43C-D385-D15C66D29296" watvalue="XM" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XM$</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" watid="AADC2BF4-BCA6-8D6B-CCEE-97C0EDC2239B" watvalue="XB" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XB$</SPAN> 年龄:<SPAN id=0E8F6861-5C36-6FAB-CCF4-7E7A62FBAD9F class=Emr_hdy wattype="static" watid="0E8F6861-5C36-6FAB-CCF4-7E7A62FBAD9F" watvalue="JZNL" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JZNL$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">门诊号码:<SPAN id=3E5EB7BC-F27E-CEA2-53B7-F2A7F5DF27E8 class=Emr_hdy wattype="static" watid="3E5EB7BC-F27E-CEA2-53B7-F2A7F5DF27E8" watvalue="MZNO" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$MZNO$</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" watid="63409F18-022B-D614-1BE3-8774FBDA1866" watvalue="PHONE" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$PHONE$</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" watid="2640A350-B623-AC1D-5F93-AAB01777693D" watvalue="结算类型" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$结算类型$</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" watid="38E38D57-A9BC-F5C6-AAEA-1C372AF33164" watvalue="JJRQ*yyyy-MM-dd" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJRQ*yyyy-MM-dd$</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" watid="F77ABC50-909D-87DB-CB99-2C5BB20720C2" watvalue="JJKS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJKS$</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">名称</FONT></TD>
<TD style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=23 width=63 align=center class><FONT style="FONT-SIZE: 2.81mm">数量</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">金额</FONT></TD></TR>
<P $data>
<TR class>
<TD style="CURSOR: default" height=23 width=121 class><SPAN id=AD320C4C-594F-93CD-47D5-289D9ADF65FE class=Emr_hdy style="FONT-SIZE: 2.81mm" wattype="static" watid="AD320C4C-594F-93CD-47D5-289D9ADF65FE" watvalue="MX项目名称" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^MX项目名称^</SPAN><FONT style="FONT-SIZE: 2.81mm"></FONT></TD>
<TD style="CURSOR: default" height=23 width=63 class><SPAN id=4261FF76-1C56-A905-8B3B-C3BCF659CDA4 class=Emr_hdy style="FONT-SIZE: 2.81mm" wattype="static" watid="4261FF76-1C56-A905-8B3B-C3BCF659CDA4" watvalue="MX项目数量" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^MX项目数量^</SPAN><SPAN id=848B211B-257D-7903-23EC-8048C5CACCC8 class=Emr_hdy style="FONT-SIZE: 2.81mm" wattype="static" watid="848B211B-257D-7903-23EC-8048C5CACCC8" watvalue="MX项目单位" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^MX项目单位^</SPAN><FONT style="FONT-SIZE: 2.81mm"></FONT></TD>
<TD style="CURSOR: default" height=23 width=97 class><SPAN id=E3279C3C-D153-080D-1600-F59655C61B05 class=Emr_hdy style="FONT-SIZE: 2.81mm" wattype="static" watid="E3279C3C-D153-080D-1600-F59655C61B05" watvalue="MX项目金额" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">^MX项目金额^</SPAN><FONT style="FONT-SIZE: 2.81mm"></FONT></TD></TR>
<P $data><FONT style="FONT-SIZE: 2.81mm"></FONT></P></TBODY></TABLE></P>
<P>
<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 bgColor=transparent border=1 class>
<TBODY>
<TR class>
<TD style="CURSOR: default" height=23 width=284 colSpan=2 class><FONT style="FONT-SIZE: 2.81mm">合计金额:<SPAN id=6ACB885E-E358-89E8-FC34-541F486D925B class=Emr_hdy wattype="static" watid="6ACB885E-E358-89E8-FC34-541F486D925B" watvalue="医疗费总额" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$医疗费总额$</SPAN> 优惠:</FONT></TD></TR>
<TR class>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm">医保个账:<SPAN id=93F80888-C5F7-10A6-FB1A-DF78EC14B558 class=Emr_hdy wattype="static" watid="93F80888-C5F7-10A6-FB1A-DF78EC14B558" watvalue="基本医疗保险统筹基金支出" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$基本医疗保险统筹基金支出$</SPAN></FONT></TD>
<TD style="CURSOR: default" height=23 width=143 class><FONT style="FONT-SIZE: 2.81mm"></FONT><FONT style="FONT-SIZE: 2.81mm">统筹支付:<SPAN id=079E01EB-B1F2-34A6-348E-DDF156B14233 class=Emr_hdy wattype="static" watid="079E01EB-B1F2-34A6-348E-DDF156B14233" watvalue="个人账户支出" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$个人账户支出$</SPAN></FONT></TD></TR>
<TR class>
<TD style="CURSOR: default" height=23 width=284 colSpan=2 class><SPAN id=6B74CE8B-B72C-8A5D-B449-43B504E46764 class=Emr_hdy style="FONT-SIZE: 2.81mm" wattype="static" watid="6B74CE8B-B72C-8A5D-B449-43B504E46764" watvalue="个人资金支付方式显示" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$个人资金支付方式显示$</SPAN><FONT style="FONT-SIZE: 2.81mm"></FONT></TD></TR>
<TR class>
<TD style="CURSOR: default" height=23 width=284 colSpan=2 class><FONT style="FONT-SIZE: 2.81mm">实收金额:<SPAN id=534941B9-6481-A08B-12D0-533DA2C3D7B2 class=Emr_hdy wattype="static" watid="534941B9-6481-A08B-12D0-533DA2C3D7B2" watvalue="个人现金支出" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$个人现金支出$</SPAN></FONT></TD></TR>
<TR class>
<TD style="CURSOR: default" width=284 colSpan=2 class><FONT style="FONT-SIZE: 2.81mm">人民币(大写):<SPAN id=D6B8CBFD-7678-67BC-D9AD-93353489DEDC class=Emr_hdy wattype="static" watid="D6B8CBFD-7678-67BC-D9AD-93353489DEDC" watvalue="个人支付额大写" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$个人支付额大写$</SPAN></FONT></TD></TR></TBODY></TABLE></P>
<P>---------------<STRONG>电子发票</STRONG>-----------------</P>
<P><STRONG>温馨提示:</STRONG></P>
<P><FONT style="FONT-SIZE: 2.81mm">★电子票据和纸质票据同等法律效力，如需纸质票据，可前往票据打印窗口进行打印</FONT></P>
<P>
<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=1 class>
<TBODY>
<TR style="HEIGHT: 186px" class>
<TD style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=186 vAlign=middle width=286 align=center class></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class><FONT style="FONT-SIZE: 2.81mm">票据代码：<SPAN id=647D4C37-6DA1-8533-5130-80655B3C5FBA class=Emr_hdy wattype="static" watid="647D4C37-6DA1-8533-5130-80655B3C5FBA" watvalue="D票据代码" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$D票据代码$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class><FONT style="FONT-SIZE: 2.81mm">票据号码：<SPAN id=98E306A0-7413-96CA-0396-C4604E3AB499 class=Emr_hdy wattype="static" watid="98E306A0-7413-96CA-0396-C4604E3AB499" watvalue="D票据号码" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$D票据号码$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class><FONT style="FONT-SIZE: 2.81mm">校验码：<SPAN id=CE3E8687-8E47-9727-C216-D6138E9EB250 class=Emr_hdy wattype="static" watid="CE3E8687-8E47-9727-C216-D6138E9EB250" watvalue="D校验码" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$D校验码$</SPAN></FONT></TD></TR>
<TR style="HEIGHT: 23px" class>
<TD style="CURSOR: default" height=23 width=286 class><FONT style="FONT-SIZE: 2.81mm">缴费时间：<SPAN id=328FC07A-24FF-0E09-08E4-1349FE8D6DB3 class=Emr_hdy wattype="static" watid="328FC07A-24FF-0E09-08E4-1349FE8D6DB3" watvalue="D缴费时间" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$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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