선택진료신청관리

- - - - - - 선택진료신청관리 선택진료신청내역 진 료 과 목 선택진료의사 성명 의사명1 의사명2 의사명3 진단검사의학과 핵의학과 병리학과 영상의학과 방사선종양학과 마취통증의학과 정신과 입원/진료일 - 환자번호 환자성명 주민번호 진료과 진료형태 선택 예약일 선택진료의사 정보 신청/의뢰 서명 선택구분 선택구분 신청일자 신청인서명 신청인관계 시작일 환자정보 * 의사정보는 1번부터 입력하십시오. 서면서명 조회조건: 진 료 과: 진료형태: 구 분: 입원/진료기간: 신청기간: 진료의: 전체 % 입원 I 외래 O 환자번호 1 환자명 2 전체 % 일괄위임 B 선택 C 비선택 N 종료일 입원 I 외래 O 일괄위임(B) B 비선택(N) N 선택(C) C 진료의 입원 I 외래 O 일괄위임(B) B 선택(C) C 비선택(N) N 참고사항

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