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HOSPITAL
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○○○○ HOSPITAL
STATEMENT OF PATIENT'S ACCOUNT
Date :
To : Addres :
Pt's Name : Room No : Dept :
Admission from : To : Days :
Cause : Diseases :
Itemizid Receipt
Interview
Blood
Room & Meals
Lab.Tests
Drugs
X-ray
Injection
C-T.MRI
Treatments
EKG.EEG
Anesthesia
Cast
Operation
Emergency care
Delivery
Others
Nurture
TOTAL
Physiotherapy
PAID
Dressing
BALANCE
Remarks :
○○○ HOSPTAL
○○-○○,○○-DONG, ○○-KU, ______, KOREA
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2007.11.26
1페이지
