klhis/file/reporttemplate/34D5F563-F591-8D63-96E9-1606713CB337/门诊检查申请单打印/4c9857cdc989c53f40b59d72df597578.xml

<?xml version="1.0" encoding="UTF-8"?>
<emr>
<page styleline="false" height="130" width="190" lineheight="1.5" letterspace="0.0"  paddingleft="10.0" paddingright="10.0" paddingtop="10.0" paddingbottom="10.0" portrait="1" />
<headercontent>
<![CDATA[




















































]]>
</headercontent>
<content>
<![CDATA[

<P></P>
<P>
<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=0>
<TBODY>
<TR class=Emr_table_dotted style="HEIGHT: 24px" class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=24 width=45 class="Emr_table_dotted"></TD>
<TD class=Emr_table_dotted style="CURSOR: default" height=24 rowSpan=3 width=62 class="Emr_table_dotted"></TD>
<TD class=Emr_table_dotted style="CURSOR: default" height=24 rowSpan=3 width=530 class="Emr_table_dotted"><FONT style="FONT-SIZE: 7.8mm"><STRONG> 新和县莎拉麦提医院检查申请单</STRONG></FONT></TD></TR>
<TR class=Emr_table_dotted style="HEIGHT: 23px" class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=45 class="Emr_table_dotted"></TD></TR>
<TR class=Emr_table_dotted style="HEIGHT: 23px" class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=45 class="Emr_table_dotted"></TD></TR></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 width="100%" bgColor=transparent border=1 class>
<TBODY></TBODY></TABLE>
<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></TBODY></TABLE>
<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></TBODY></TABLE></P>
<P>
<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=0>
<TBODY>
<TR class=Emr_table_dotted class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=390 class="Emr_table_dotted">门诊号：<SPAN id=A7819BB6-0462-CF5A-6342-7F37AB56686C class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="MZNO" watid="A7819BB6-0462-CF5A-6342-7F37AB56686C">$MZNO$</SPAN></TD>
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=248 colSpan=2 class="Emr_table_dotted">姓名：<SPAN id=A826240C-A651-5654-E7E6-6DC566B327BA class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="XM" watid="A826240C-A651-5654-E7E6-6DC566B327BA">$XM$</SPAN></TD></TR>
<TR class=Emr_table_dotted class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=390 class="Emr_table_dotted">科别：<SPAN id=F00CB2D1-40F3-3CDB-720A-7433C1B78C8E class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="JJKS" watid="F00CB2D1-40F3-3CDB-720A-7433C1B78C8E">$JJKS$</SPAN></TD>
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=78 class="Emr_table_dotted">性别：<SPAN id=69F9BE6C-BA5B-1868-2464-F70935CF8CF4 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="XB" watid="69F9BE6C-BA5B-1868-2464-F70935CF8CF4">$XB$</SPAN></TD>
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=169 class="Emr_table_dotted">年龄：<SPAN id=04962305-8D09-9572-1753-82CB3547A8D1 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="JZNL" watid="04962305-8D09-9572-1753-82CB3547A8D1">$JZNL$</SPAN></TD></TR></TBODY></TABLE>
<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=0>
<TBODY>
<TR class=Emr_table_dotted class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=371 class="Emr_table_dotted"><STRONG>临床诊断：<SPAN id=4F8A1BC1-765E-1725-8EC6-AB85772FA720 class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="诊断" watid="4F8A1BC1-765E-1725-8EC6-AB85772FA720">$诊断$</SPAN></STRONG></TD>
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=267 class="Emr_table_dotted"><STRONG>检查目的：<SPAN id=D949817F-A0AE-B1EC-61DB-BA1861E48E5A class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="JCMD" watid="D949817F-A0AE-B1EC-61DB-BA1861E48E5A">$JCMD$</SPAN></STRONG></TD></TR>
<TR class=Emr_table_dotted class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=641 colSpan=2 class="Emr_table_dotted"><STRONG>病史摘要:<SPAN id=DA7862E3-BE3E-40E9-ADA8-5F37133F161B class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="ZS" watid="DA7862E3-BE3E-40E9-ADA8-5F37133F161B">$ZS$</SPAN></STRONG></TD></TR>
<TR class=Emr_table_dotted class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" width=641 colSpan=2 class="Emr_table_dotted"></TD></TR></TBODY></TABLE></P>
<P></P>
<P></P>
<P></P>
<DIV contentEditable=false style="FONT-SIZE: 0px; HEIGHT: 1px">
<HR style="BORDER-TOP: 0px; HEIGHT: 1px; BORDER-RIGHT: 0px; BORDER-BOTTOM: 0px; BORDER-LEFT: 0px; BACKGROUND-COLOR: #000000">
</DIV>
<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>
<P $data>
<P $data></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 width="100%" bgColor=transparent border=1 class>
<TBODY>
<P $data>
<P $data></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 width="100%" bgColor=transparent border=1 class>
<TBODY>
<P $data>
<P $data></P></TBODY></TABLE>
<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#ffffff cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=1 class>
<TBODY>
<TR class>
<TD style="CURSOR: default" height=23 width=100 class></TD>
<TD style="CURSOR: default" height=23 width=218 class></TD>
<TD style="CURSOR: default" height=23 width=94 class>数量</TD>
<TD style="CURSOR: default" height=23 width=224 class>执行科室</TD></TR>
<P $data>
<TR class>
<TD style="CURSOR: default" height=23 width=100 class></TD>
<TD style="CURSOR: default" height=23 width=218 class><SPAN id=DC641800-A419-5BE7-F354-3AFA556A565F class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="YZMC" watid="DC641800-A419-5BE7-F354-3AFA556A565F">^YZMC^</SPAN></TD>
<TD style="CURSOR: default" height=23 width=94 class><SPAN id=A1B32F7E-F56F-EA45-3B6C-4B3BC50838CE class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="YZSL" watid="A1B32F7E-F56F-EA45-3B6C-4B3BC50838CE">^YZSL^</SPAN></TD>
<TD style="CURSOR: default" height=23 width=224 class><SPAN id=8419D10A-3D0B-796A-EDAB-A2727CB76D0A class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="YZZXKS" watid="8419D10A-3D0B-796A-EDAB-A2727CB76D0A">^YZZXKS^</SPAN></TD></TR>
<P $data></P></TBODY></TABLE></P>
<P>
<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=0>
<TBODY>
<TR class=Emr_table_dotted class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=373 class="Emr_table_dotted"></TD>
<TD class=Emr_table_dotted style="CURSOR: default" height=23 width=265 class="Emr_table_dotted">
<P>&nbsp;</P>
<P>签名：</P></TD></TR></TBODY></TABLE></P>
<P>
<TABLE style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 bgColor=transparent border=1 class>
<TBODY></TBODY></TABLE></P>
<P></P>
<DIV contentEditable=false style="FONT-SIZE: 0px; HEIGHT: 1px">
<HR style="BORDER-TOP: 0px; HEIGHT: 1px; BORDER-RIGHT: 0px; BORDER-BOTTOM: 0px; BORDER-LEFT: 0px; BACKGROUND-COLOR: #000000">
</DIV>
<P>
<TABLE class=Emr_table_dotted style="FONT-SIZE: 3.7mm; FONT-FAMILY: 宋体; WIDTH: 100%; BORDER-COLLAPSE: collapse; LINE-HEIGHT: 1.5" borderColor=#bfbfbf cellSpacing=0 cellPadding=0 width="100%" bgColor=transparent border=0>
<TBODY>
<TR class=Emr_table_dotted style="HEIGHT: 24px" class="Emr_table_dotted">
<TD class=Emr_table_dotted style="CURSOR: default" height=24 width=374 colSpan=2 class="Emr_table_dotted">申请医生：<SPAN id=2E9BF9D9-91F0-C4AE-1F83-F0E27E61D70F class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="BUILDER" watid="2E9BF9D9-91F0-C4AE-1F83-F0E27E61D70F">$BUILDER$</SPAN></TD>
<TD class=Emr_table_dotted style="CURSOR: default" height=24 width=263 class="Emr_table_dotted">申请日期：<SPAN id=A694230D-F231-BEA2-F127-608448680D2B class=Emr_hdy wattype="static" watflag="true" watsuntype="s2" wathdychange="false" watencryptshow="false" watdelete="false" watvalue="BUILDDATE*yyyy-MM-dd" watid="A694230D-F231-BEA2-F127-608448680D2B">$BUILDDATE*yyyy-MM-dd$</SPAN></TD></TR></TBODY></TABLE></P>
]]>
</content>
<footercontent>
<![CDATA[




















































]]>
</footercontent>
</emr>