|
@@ -0,0 +1,114 @@
|
|
1
|
+<template>
|
|
2
|
+ <div id="statement-print" class="statement-print">
|
|
3
|
+ <div class="statementTitle">费用明细算单</div>
|
|
4
|
+ <div class="statementTable">
|
|
5
|
+ <table border="1" style="border-collapse: collapse;width: 100%;border: none;">
|
|
6
|
+ <tr>
|
|
7
|
+ <td colspan="4">医院机构名称:</td>
|
|
8
|
+ <td colspan="4">发票号:</td>
|
|
9
|
+ </tr>
|
|
10
|
+ <tr style="border-bottom: 1px solid black;">
|
|
11
|
+ <td colspan="4" >单据编码:</td>
|
|
12
|
+ <td colspan="2" >就诊时间:</td>
|
|
13
|
+ <td colspan="2" >金额单位:元</td>
|
|
14
|
+ </tr>
|
|
15
|
+ <tr>
|
|
16
|
+ <td colspan="4">姓名:</td>
|
|
17
|
+ <td colspan="4">身份证号:</td>
|
|
18
|
+ </tr>
|
|
19
|
+ <tr>
|
|
20
|
+ <td colspan="8">诊断:</td>
|
|
21
|
+ </tr>
|
|
22
|
+ <tr style="border-bottom: 1px solid black;">
|
|
23
|
+ <td colspan="4">人员类别:</td>
|
|
24
|
+ <td colspan="4">险种类型:</td>
|
|
25
|
+ </tr>
|
|
26
|
+ <tr style="border-bottom: 1px solid black;text-align: center;">
|
|
27
|
+ <td width="12.5%">项目</td>
|
|
28
|
+ <td width="12.5%">金额</td>
|
|
29
|
+ <td width="12.5%">项目</td>
|
|
30
|
+ <td width="12.5%">金额</td>
|
|
31
|
+ <td width="12.5%">项目</td>
|
|
32
|
+ <td width="12.5%">金额</td>
|
|
33
|
+ <td width="12.5%">项目</td>
|
|
34
|
+ <td width="12.5%">金额</td>
|
|
35
|
+ </tr>
|
|
36
|
+ <tr style="text-align: center;">
|
|
37
|
+ <td>西药费</td>
|
|
38
|
+ <td>金额</td>
|
|
39
|
+ <td>化验费</td>
|
|
40
|
+ <td>金额</td>
|
|
41
|
+ <td>治疗费</td>
|
|
42
|
+ <td>金额</td>
|
|
43
|
+ <td>处置费</td>
|
|
44
|
+ <td>金额</td>
|
|
45
|
+ </tr>
|
|
46
|
+ <tr style="text-align: center;">
|
|
47
|
+ <td>中成药</td>
|
|
48
|
+ <td>金额</td>
|
|
49
|
+ <td>诊疗费</td>
|
|
50
|
+ <td>金额</td>
|
|
51
|
+ <td>材料费</td>
|
|
52
|
+ <td>金额</td>
|
|
53
|
+ <td>护理费</td>
|
|
54
|
+ <td>金额</td>
|
|
55
|
+ </tr>
|
|
56
|
+ <tr style="text-align: center;">
|
|
57
|
+ <td>注射费</td>
|
|
58
|
+ <td>金额</td>
|
|
59
|
+ <td>检查费</td>
|
|
60
|
+ <td>金额</td>
|
|
61
|
+ <td>输氧费</td>
|
|
62
|
+ <td>金额</td>
|
|
63
|
+ <td>其他</td>
|
|
64
|
+ <td>金额</td>
|
|
65
|
+ </tr>
|
|
66
|
+ <tr style="border-bottom: 1px solid black; font: 16px bolder;">
|
|
67
|
+ <td colspan="8">合计:</td>
|
|
68
|
+ </tr>
|
|
69
|
+ <tr>
|
|
70
|
+ <td colspan="8">医保基金支付金额:</td>
|
|
71
|
+ </tr>
|
|
72
|
+ <tr style="border-bottom: 1px solid black;">
|
|
73
|
+ <td colspan="8">个人现金支付金额:</td>
|
|
74
|
+ </tr>
|
|
75
|
+ <tr>
|
|
76
|
+ <td colspan="2">家属或参保人签名:</td>
|
|
77
|
+ <td colspan="2">收费员签名:</td>
|
|
78
|
+ <td colspan="2">医院盖章:</td>
|
|
79
|
+ </tr>
|
|
80
|
+ <tr>
|
|
81
|
+ <td colspan="8">医师签名:</td>
|
|
82
|
+ </tr>
|
|
83
|
+ </table>
|
|
84
|
+ </div>
|
|
85
|
+ </div>
|
|
86
|
+</template>
|
|
87
|
+
|
|
88
|
+<style lang="scss" scoped>
|
|
89
|
+.statement-print {
|
|
90
|
+ -webkit-box-shadow: 0 1px 4px rgba(0, 0, 0, 0.27), 0 0 60px rgba(0, 0, 0, 0.06) inset;
|
|
91
|
+ -moz-box-shadow: 0 1px 4px rgba(0, 0, 0, 0.27), 0 0 40px rgba(0, 0, 0, 0.06) inset;
|
|
92
|
+ box-shadow: 0 1px 4px rgba(0, 0, 0, 0.27), 0 0 40px rgba(0, 0, 0, 0.06) inset;
|
|
93
|
+ margin-bottom: 20px;
|
|
94
|
+ padding: 20px 10px;
|
|
95
|
+}
|
|
96
|
+.statementTitle {
|
|
97
|
+ font-size: 28px;
|
|
98
|
+ text-align: center;
|
|
99
|
+ font-weight: bold;
|
|
100
|
+ margin-bottom: 10px;
|
|
101
|
+}
|
|
102
|
+.statementTable {
|
|
103
|
+ width: 100%;
|
|
104
|
+ font-size: 14px;
|
|
105
|
+ word-wrap: break-word;
|
|
106
|
+ word-break: break-all;
|
|
107
|
+ table tr td{
|
|
108
|
+ padding: 5px;
|
|
109
|
+ line-height: 30px;
|
|
110
|
+ border: none;
|
|
111
|
+ }
|
|
112
|
+}
|
|
113
|
+
|
|
114
|
+</style>
|