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<?xml version="1.0" encoding="UTF-8"?>
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<emr>
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<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" />
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<headercontent>
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</headercontent>
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<content>
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<![CDATA[
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<P></P>
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<P></P>
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<P align=center>
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<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>
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<TBODY></TBODY></TABLE>
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<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>
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<TBODY>
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<TR style="BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: ">
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<TD style="CURSOR: default" height=23 rowSpan=4 width=139></TD>
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<TD style="CURSOR: default" height=23 rowSpan=2 width=306 colSpan=2><FONT style="FONT-SIZE: 7.8mm"><STRONG>
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<CENTER><SPAN id=7417F9DB-DE2C-EE5F-1737-4B19FF4D0BDA class=Emr_hdy style="TEXT-ALIGN-LAST: left; TEXT-ALIGN: justify; TEXT-JUSTIFY: inter-ideograph; MozTextAlignLast: justify; WebkitTextAlignLast: justify" align="center" wattype="static" watid="7417F9DB-DE2C-EE5F-1737-4B19FF4D0BDA" watvalue="COMPANYID" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$COMPANYID$</SPAN></CENTER></STRONG></FONT></TD>
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<TD style="CURSOR: default" height=23 rowSpan=2 width=195>住院证号：<SPAN id=951B5565-21BF-5B00-BBAC-0F4E4FF21A6A class=Emr_hdy wattype="static" watid="951B5565-21BF-5B00-BBAC-0F4E4FF21A6A" watvalue="ZYZH" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$ZYZH$</SPAN></TD></TR>
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<TR></TR>
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<TR>
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<TD style="CURSOR: default" height=23 rowSpan=2 width=306 colSpan=2><FONT style="FONT-SIZE: 7.8mm"><STRONG> 住院通知单</STRONG></FONT></TD>
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<TD style="CURSOR: default" height=23 width=195>费用类别：<SPAN id=D8EAD093-3067-198C-EFF5-2BFBD06D993D class=Emr_hdy wattype="static" watid="D8EAD093-3067-198C-EFF5-2BFBD06D993D" watvalue="HZLX" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$HZLX$</SPAN></TD></TR>
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<TR>
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<TD style="CURSOR: default" height=23 width=195>拟住科室：<SPAN id=903095E7-19A2-B76C-459F-E797A7D7004E class=Emr_hdy wattype="static" watid="903095E7-19A2-B76C-459F-E797A7D7004E" watvalue="ZYKS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$ZYKS$</SPAN></TD></TR></TBODY></TABLE></P>
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<P></P>
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<P></P>
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<DIV contentEditable=false style="FONT-SIZE: 0px; HEIGHT: 1px">
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<HR style="BORDER-TOP: 0px; HEIGHT: 1px; BORDER-RIGHT: 0px; BORDER-BOTTOM: 0px; BORDER-LEFT: 0px; BACKGROUND-COLOR: #000000">
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</DIV>
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<P></P>
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<P></P>
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<P></P>
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<P>
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<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>
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<TBODY>
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<TR>
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<TD style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=25 width=245>姓 名：<SPAN id=5613F4B9-B5BF-085E-997E-3B45B33BA2B1 class=Emr_hdy wattype="static" watid="5613F4B9-B5BF-085E-997E-3B45B33BA2B1" watvalue="XM" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XM$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=84>性别：<SPAN id=B6DD6788-5E5E-0873-3BC5-294390792F46 class=Emr_hdy wattype="static" watid="B6DD6788-5E5E-0873-3BC5-294390792F46" watvalue="XB" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XB$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=123>年龄：<SPAN id=1BFF3658-8087-DE5C-4250-81F8AFC0E67A class=Emr_hdy wattype="static" watid="1BFF3658-8087-DE5C-4250-81F8AFC0E67A" watvalue="JZNL" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JZNL$</SPAN></TD>
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<TD style="CURSOR: default" width=187 colSpan=2> 族别：<SPAN id=9E2F4F02-195C-D084-D0B9-AD97A46AE348 class=Emr_hdy wattype="static" watid="9E2F4F02-195C-D084-D0B9-AD97A46AE348" watvalue="MZ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$MZ$</SPAN></TD></TR>
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<TR>
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<TD style="CURSOR: default" height=23 width=452 colSpan=3>住 址：<SPAN id=872503D0-6E01-3F86-CD4A-DD53A99A423E class=Emr_hdy wattype="static" watid="872503D0-6E01-3F86-CD4A-DD53A99A423E" watvalue="XZDZ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$XZDZ$</SPAN><SPAN> </SPAN></TD>
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<TD style="CURSOR: default" width=187 colSpan=2> 职业：<SPAN id=695E8295-FB40-4632-1013-0C057C6B726D class=Emr_hdy wattype="static" watid="695E8295-FB40-4632-1013-0C057C6B726D" watvalue="ZY" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$ZY$</SPAN></TD></TR>
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<TR>
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<TD style="CURSOR: default" height=23 width=245>身份证：<SPAN id=1F0FDC68-712F-1CE0-307F-63915D0F5B4A class=Emr_hdy wattype="static" watid="1F0FDC68-712F-1CE0-307F-63915D0F5B4A" watvalue="SFZH" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$SFZH$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=406 colSpan=4>联系方式：<SPAN id=510EFE21-1B1D-E858-5A3A-879CD0100678 class=Emr_hdy wattype="static" watid="510EFE21-1B1D-E858-5A3A-879CD0100678" watvalue="PHONE" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$PHONE$</SPAN><SPAN> </SPAN></TD></TR>
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<TR>
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<TD style="CURSOR: default" height=23 width=245>负责人：<SPAN id=69ABBD0A-8EC4-33C6-0AAC-88366A114FD6 class=Emr_hdy wattype="static" watid="69ABBD0A-8EC4-33C6-0AAC-88366A114FD6" watvalue="LXR" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$LXR$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=207 colSpan=2>与患者关系：<SPAN id=4191BAF7-1545-FC03-5656-EA7F3FF87381 class=Emr_hdy wattype="static" watid="4191BAF7-1545-FC03-5656-EA7F3FF87381" watvalue="LXRGX" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$LXRGX$</SPAN></TD>
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<TD style="CURSOR: default" width=187 colSpan=2> 联系方式：<SPAN id=63B36A32-B7C8-6635-F235-FD2926BAB681 class=Emr_hdy wattype="static" watid="63B36A32-B7C8-6635-F235-FD2926BAB681" watvalue="LXRDH" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$LXRDH$</SPAN></TD></TR></TBODY></TABLE></P>
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<P>
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<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>
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<TBODY>
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<TR style="HEIGHT: 23px">
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<TD style="CURSOR: default; BORDER-TOP-COLOR: ; BORDER-LEFT-COLOR: ; BORDER-BOTTOM-COLOR: ; BORDER-RIGHT-COLOR: " height=25 width=641 colSpan=3>
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<P>入院诊断：<SPAN id=01BA33AF-6B4C-7E09-8446-72AB78975C06 class=Emr_hdy wattype="static" watid="01BA33AF-6B4C-7E09-8446-72AB78975C06" watvalue="LCZD" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$LCZD$</SPAN><SPAN> </SPAN></P></TD></TR>
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<TR style="HEIGHT: 23px">
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<TD style="CURSOR: default" height=23 width=214>入院情况：<SPAN id=B2E4789E-1085-D1E7-ED0C-ED295A0E2A26 class=Emr_hdy wattype="static" watid="B2E4789E-1085-D1E7-ED0C-ED295A0E2A26" watvalue="RYBQ" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$RYBQ$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=214>预收款：<SPAN id=8705E433-C860-1EB4-1AAB-C4A70D7E9C37 class=Emr_hdy wattype="static" watid="8705E433-C860-1EB4-1AAB-C4A70D7E9C37" watvalue="ZYJY" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$ZYJY$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=214>收款人：<U> </U><U> </U><U> </U><U> </U><U> </U><U> </U><U> </U><U> </U><U> </U><U> </U></TD></TR>
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<TR style="HEIGHT: 23px">
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<TD style="CURSOR: default" height=23 width=214>门诊医师：<SPAN id=F12BCC36-5F75-88C7-C081-FF22CE4CFB7D class=Emr_hdy wattype="static" watid="F12BCC36-5F75-88C7-C081-FF22CE4CFB7D" watvalue="JJYS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJYS$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=214>就诊科室：<SPAN id=6B3257EE-96F2-D8B0-F1A5-E9ADC69B79B1 class=Emr_hdy wattype="static" watid="6B3257EE-96F2-D8B0-F1A5-E9ADC69B79B1" watvalue="JJKS" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJKS$</SPAN></TD>
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<TD style="CURSOR: default" height=23 width=214>时间：<SPAN id=F2C3BC1F-E23F-A08A-4623-291BC93452D5 class=Emr_hdy wattype="static" watid="F2C3BC1F-E23F-A08A-4623-291BC93452D5" watvalue="JJRQ*yyyy-MM-dd" watdelete="false" watencryptshow="false" wathdychange="false" watsuntype="s2" watflag="true">$JJRQ*yyyy-MM-dd$</SPAN></TD></TR></TBODY></TABLE></P>
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<P></P>
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<P></P>
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<DIV contentEditable=false style="FONT-SIZE: 0px; HEIGHT: 1px">
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<HR style="BORDER-TOP: 0px; HEIGHT: 1px; BORDER-RIGHT: 0px; BORDER-BOTTOM: 0px; BORDER-LEFT: 0px; BACKGROUND-COLOR: #000000">
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</DIV>
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<P></P>
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<P></P>
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<P></P>
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<P>尊敬的患者:</P>
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<P> 您好！感谢您对莎拉麦提医院的信任，本单仅为患者需住院治疗的证明，如我院无床或病情不允许久等者，病人须自己到其他医疗机构就诊，以免延误病情。</P>
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<P> 请您办理住院手续后8小时内到护士站办理入科手续，超时将无法入科，需要在窗口重新办理住院，方可入科。</P>
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<P></P>
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]]>
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</content>
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</emr> |
