YNU_JEUS/app_home/himed/webapps/pam/patinfomngtweb/rex/RPPMC09300_진료비후불서비스신청서.rex

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Text="진료비 후불(easy pass)서비스 신청서" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="18" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Table" Name="표2" Visible="0" X1="200" Y1="1400" Width="1700" Height="921" FitSection="0" LinkIndex="1" RoundLeftTopEdge="0" RoundRightTopEdge="0" RoundRightBottomEdge="0" RoundLeftBottomEdge="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><CellStyles><CellStyle LeftLineStyle="0" RightLineStyle="0" TopLineStyle="0" BottomLineStyle="0" FDiagonalLineStyle="0" BDiagonalLineStyle="0" LeftLineWidth="0" RightLineWidth="0" 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2.



3.


※

4.

※" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="5" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="10" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="0" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="0" CanGrow="0" CanShrink="0" DataType="0" Text="외래 진료비의 경우 : 외래진료 당일 발생된 모든 진료과의 진찰료 및 검사료를 당일 귀가 전
수납창구를 방문하여 일괄 결제하겠습니다. 만일 미결제 귀가 시에는 익일 신청인의 휴대전
화로 결제내역을 SMS로 전송합니다. 
진료 건당 결제 금액이 5만원 이상일 경우 할부 가능

입원 진료비의 경우 : 입원기간 중 발생되는 모든 진료과의 입원료 및 치료비 일체를 퇴원
당일 귀가 전 수납창구를 방문하여 일괄 결제하겠습니다. 다만 입원기간이 10일을 초과할
경우 중간정산 결제하는데 동의합니다. 

수납창구를 방문하지 못하고 귀가할 경우, 귀원의 수납담당자가 사전에 신청된 신용카드로
일괄 결제함에 동의합니다. 이 경우 외래 예약시 사전에 검사비를 수납하는 검사의 경우에는
다른 의사 표시가 없는 한 일괄 결제됩니다. 
이미 시행된 진료 및 검사료에 대해서는 환불이 되지 않습니다.

후불 신청기간은 선택가능하며, 카드 관련 개인정보도 신청기간 동안 수집 보관하는데 동의 합니다.
본원은 신청인이 요청할 경우 결제내역(영수증 등)을 제공합니다. " MultiLine="1" WordWrap="1" WordSpace="4" LineSpace="5" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="10" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="0" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell></Row></Rows><Cols><Col Size="62"/><Col Size="1638"/></Cols><ConditionalStyles/></Control><Control Type="Control.Image" Name="그림1" Visible="0" X1="150" Y1="250" Width="400" Height="150" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" SizeMode="4" SourceType="0" Embedding="1" Path="" Frame="0" ImageFormat="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0" DataFieldID="-1" DataFieldIndex="-1"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles><ConditionalStyle GlobalStyleIndex="2"><Condition OperationFieldID="1" OperationFieldIndex="13" OperationFieldAdjustCrosstabRowColumnType="0" OperationFieldAdjustCrosstabRowColumnIndex="-1" ConditionID="0" FirstItemDataType="0" FirstItemValue="032" FirstItemFieldID="-1" FirstItemFieldIndex="-1" FirstItemFieldAdjustCrosstabRowColumnType="0" FirstItemFieldAdjustCrosstabRowColumnIndex="-1" SecondItemDataType="0" SecondItemValue="" SecondItemFieldID="-1" SecondItemFieldIndex="-1" SecondItemFieldAdjustCrosstabRowColumnType="0" SecondItemFieldAdjustCrosstabRowColumnIndex="-1"/></ConditionalStyle><ConditionalStyle GlobalStyleIndex="3"><Condition OperationFieldID="1" OperationFieldIndex="13" OperationFieldAdjustCrosstabRowColumnType="0" OperationFieldAdjustCrosstabRowColumnIndex="-1" ConditionID="1" FirstItemDataType="0" FirstItemValue="032" FirstItemFieldID="-1" FirstItemFieldIndex="-1" FirstItemFieldAdjustCrosstabRowColumnType="0" FirstItemFieldAdjustCrosstabRowColumnIndex="-1" SecondItemDataType="0" SecondItemValue="" SecondItemFieldID="-1" SecondItemFieldIndex="-1" SecondItemFieldAdjustCrosstabRowColumnType="0" SecondItemFieldAdjustCrosstabRowColumnIndex="-1"/></ConditionalStyle></ConditionalStyles><![CDATA[/9j/
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ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="1" BaseCellRowIndex="1" BaseCellColIndex="1"/><Cell CellType="1" BaseCellRowIndex="1" BaseCellColIndex="1"/><Cell CellType="1" BaseCellRowIndex="1" BaseCellColIndex="1"/><Cell CellType="1" BaseCellRowIndex="1" BaseCellColIndex="1"/><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="유효기간" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="         년         월" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell></Row><Row Size="87"><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="결제대상" MultiLine="1" WordWrap="1" WordSpace="10" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="외래진료비 및 입원진료비" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="2" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="1" BaseCellRowIndex="2" BaseCellColIndex="2"/><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="신용카드 유효기간과 동일" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="3" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="1" BaseCellRowIndex="2" BaseCellColIndex="5"/><Cell CellType="1" BaseCellRowIndex="2" BaseCellColIndex="5"/></Row></Rows><Cols><Col Size="300"/><Col Size="100"/><Col Size="250"/><Col Size="300"/><Col Size="100"/><Col Size="100"/><Col Size="200"/><Col Size="350"/></Cols><ConditionalStyles/></Control><Control Type="Control.CheckBox" Name="체크박스1" Visible="0" X1="525" Y1="1142" Width="50" Height="50" CheckStyle="0" CheckColor="0" ShowOutterLine="1" CheckValue="1" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0" DataFieldID="-1" DataFieldIndex="-1"><ConditionalStyles><ConditionalStyle GlobalStyleIndex="0"><Condition OperationFieldID="1" OperationFieldIndex="10" OperationFieldAdjustCrosstabRowColumnType="0" OperationFieldAdjustCrosstabRowColumnIndex="-1" ConditionID="0" FirstItemDataType="0" FirstItemValue="O" FirstItemFieldID="-1" FirstItemFieldIndex="-1" FirstItemFieldAdjustCrosstabRowColumnType="0" FirstItemFieldAdjustCrosstabRowColumnIndex="-1" SecondItemDataType="0" SecondItemValue="" SecondItemFieldID="-1" SecondItemFieldIndex="-1" SecondItemFieldAdjustCrosstabRowColumnType="0" SecondItemFieldAdjustCrosstabRowColumnIndex="-1"/></ConditionalStyle><ConditionalStyle GlobalStyleIndex="1"><Condition OperationFieldID="1" OperationFieldIndex="10" OperationFieldAdjustCrosstabRowColumnType="0" OperationFieldAdjustCrosstabRowColumnIndex="-1" ConditionID="1" FirstItemDataType="0" FirstItemValue="O" FirstItemFieldID="-1" FirstItemFieldIndex="-1" FirstItemFieldAdjustCrosstabRowColumnType="0" FirstItemFieldAdjustCrosstabRowColumnIndex="-1" SecondItemDataType="0" SecondItemValue="" SecondItemFieldID="-1" SecondItemFieldIndex="-1" SecondItemFieldAdjustCrosstabRowColumnType="0" SecondItemFieldAdjustCrosstabRowColumnIndex="-1"/></ConditionalStyle></ConditionalStyles></Control><Control Type="Control.CheckBox" Name="체크박스2" Visible="0" X1="1176" Y1="1142" Width="50" Height="50" CheckStyle="0" CheckColor="16777215" ShowOutterLine="1" CheckValue="1" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0" DataFieldID="-1" DataFieldIndex="-1"><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자2" Visible="0" X1="200" Y1="1250" Width="1700" Height="100" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="1" Text="위 본인은 칠곡경북대학교병원의 진료과정에서 발생되는 모든 비용을 상기 기입한 신용카드로 지불하는것에 동의 합니다." MultiLine="1" WordWrap="1" WordSpace="3" LineSpace="3" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자3" Visible="0" X1="200" Y1="2350" Width="1700" Height="69" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="1" Text="상기내용에 관하여 충분히 숙지하였으며, 진료비를 신용카드로 후불하고자 위와 같이 신청합니다." MultiLine="1" WordWrap="1" WordSpace="3" LineSpace="3" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Table" Name="표4" Visible="0" X1="1200" Y1="2450" Width="700" Height="200" FitSection="0" LinkIndex="4" RoundLeftTopEdge="0" RoundRightTopEdge="0" RoundRightBottomEdge="0" RoundLeftBottomEdge="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><CellStyles><CellStyle LeftLineStyle="0" RightLineStyle="0" TopLineStyle="0" BottomLineStyle="0" FDiagonalLineStyle="0" BDiagonalLineStyle="0" LeftLineWidth="0" RightLineWidth="0" TopLineWidth="0" BottomLineWidth="0" FDiagonalLineWidth="0.75" BDiagonalLineWidth="0.75" LeftLineColor="0" RightLineColor="0" TopLineColor="0" BottomLineColor="0" FDiagonalLineColor="0" BDiagonalLineColor="0"/></CellStyles><Rows><Row Size="100"><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="신청일 :" MultiLine="1" WordWrap="1" WordSpace="5" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="2" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="1" Text="!rgstdd" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="3" FieldIndex="10" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell></Row><Row Size="100"><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="1" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="신청자 :" MultiLine="1" WordWrap="1" WordSpace="5" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="2" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="(인)" MultiLine="1" WordWrap="1" WordSpace="0" LineSpace="0" Editable="0" AutoFontSize="0" RowSpan="1" ColSpan="1" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" MergeIfSuppress="0" MergeColumn="0" AddEnterWhenMergeColumn="0" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="9" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell></Row></Rows><Cols><Col Size="250"/><Col Size="450"/></Cols><ConditionalStyles/></Control><Control Type="Control.Field" Name="필드1" Visible="0" X1="1200" Y1="2650" Width="700" Height="100" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="2" VerticalAlignment="1" MultiLine="1" WordWrap="1" WordSpace="3" LineSpace="0" Editable="0" AutoFontSize="0" CanGrow="0" CanShrink="0" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="13" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" Text="!hospname2" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0" FieldID="3" FieldIndex="1"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Field" Name="필드2" Visible="0" X1="368" Y1="1244" Width="350" Height="54" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="1" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="2" VerticalAlignment="1" MultiLine="1" WordWrap="1" WordSpace="3" LineSpace="0" Editable="0" AutoFontSize="0" CanGrow="0" CanShrink="0" OutputFormat="" ReplaceEmpty="" SuppressIfDuplication="0" SuppressIfZero="0" SuppressText="" SummaryFunction="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" Text="!hospname" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0" FieldID="3" FieldIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자4" Visible="0" X1="262" Y1="1400" Width="344" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="1" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="1" Text="외래 진료비의 경우" MultiLine="1" WordWrap="1" WordSpace="4" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자5" Visible="0" X1="262" Y1="1664" Width="344" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="1" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="1" Text="입원 진료비의 경우" MultiLine="1" WordWrap="1" WordSpace="4" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자6" Visible="0" X1="262" Y1="1880" Width="750" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="1" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="1" Text="수납창구를 방문하지 못하고 귀가할 경우," MultiLine="1" WordWrap="1" WordSpace="4" LineSpace="0" Editable="0" AutoFontSize="0" TopMargin="0" LeftMargin="0" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="1" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" ExportLeft="0" ExportTop="0" ExportRight="0" ExportBottom="0"><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/></Control><Control Type="Control.Label" Name="글상자7" Visible="0" X1="263" Y1="2042" Width="1137" Height="50" LineStyle="0" LineWidth="0.75" LineColor="0" RoundRate="0" SquareRound="0" BackStyle="1" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="1" Text="이미 시행된 진료 및 검사료에 대해서는 환불이 되지 않습니다." 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