klhis/file/reporttemplate/DE3C9D58-C91A-459E-74D0-5897CAC5F92B/检查申请单打印/236d1543423c40666f463211f80eed6a.xml

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<TD style="CURSOR: default" height=24 rowSpan=3 width=481 class><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>
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<TD style="CURSOR: default" height=23 width=390 class>门诊号：<SPAN id=A7819BB6-0462-CF5A-6342-7F37AB56686C class=Emr_hdy wattype="static" watid="A7819BB6-0462-CF5A-6342-7F37AB56686C" watvalue="MZNO" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$MZNO$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=248 colSpan=2 class>姓名：<SPAN id=A826240C-A651-5654-E7E6-6DC566B327BA class=Emr_hdy wattype="static" watid="A826240C-A651-5654-E7E6-6DC566B327BA" watvalue="XM" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XM$</SPAN></TD></TR>
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<TD style="CURSOR: default" height=23 width=390 class>科别：<SPAN id=F00CB2D1-40F3-3CDB-720A-7433C1B78C8E class=Emr_hdy wattype="static" watid="F00CB2D1-40F3-3CDB-720A-7433C1B78C8E" watvalue="JJKS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJKS$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=78 class>性别：<SPAN id=69F9BE6C-BA5B-1868-2464-F70935CF8CF4 class=Emr_hdy wattype="static" watid="69F9BE6C-BA5B-1868-2464-F70935CF8CF4" watvalue="XB" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XB$</SPAN></TD>
<TD style="CURSOR: default" height=23 width=169 class>年龄：<SPAN id=04962305-8D09-9572-1753-82CB3547A8D1 class=Emr_hdy wattype="static" watid="04962305-8D09-9572-1753-82CB3547A8D1" watvalue="JZNL" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JZNL$</SPAN></TD></TR></TBODY></TABLE>
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<TD style="CURSOR: default" height=23 width=371 class><STRONG>临床诊断：</STRONG></TD>
<TD style="CURSOR: default" height=23 width=267 class><STRONG>检查目的：<SPAN id=D949817F-A0AE-B1EC-61DB-BA1861E48E5A class=Emr_hdy wattype="static" watid="D949817F-A0AE-B1EC-61DB-BA1861E48E5A" watvalue="JCMD" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JCMD$</SPAN></STRONG></TD></TR>
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<TD style="CURSOR: default" height=23 width=641 colSpan=2 class><STRONG>病史摘要:</STRONG></TD></TR>
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<TD style="CURSOR: default" height=23 width=321 class>检查项目</TD>
<TD style="CURSOR: default" height=23 width=321 class>执行科室</TD></TR>
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<P>&nbsp;</P>
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<TD style="CURSOR: default" height=23 width=265 class>签名：</TD></TR></TBODY></TABLE></P>
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<TD style="CURSOR: default" height=24 width=374 colSpan=2 class>申请医生：<SPAN id=2E9BF9D9-91F0-C4AE-1F83-F0E27E61D70F class=Emr_hdy wattype="static" watid="2E9BF9D9-91F0-C4AE-1F83-F0E27E61D70F" watvalue="BUILDER" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$BUILDER$</SPAN></TD>
<TD style="CURSOR: default" height=24 width=263 class>申请日期：<SPAN id=A694230D-F231-BEA2-F127-608448680D2B class=Emr_hdy wattype="static" watid="A694230D-F231-BEA2-F127-608448680D2B" watvalue="BUILDDATE*yyyy-MM-dd" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$BUILDDATE*yyyy-MM-dd$</SPAN></TD></TR></TBODY></TABLE>
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