영문 영수증(병원치료)

○ ○ ○ ○ 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 :

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○ ○  ○ HOSPTAL

○ ○- ○ ○, ○ ○-DONG,  ○ ○-KU, ______, KOREA