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Date medic Numãr parafã*       Numãr contract*

Date pacient CNP* Casa de asigurãri* Nume* Tip asigurat * Prenume* Nr. inreg * Tara de origine * GEORGIA UCRAINA ABRACADABRA PRFITALIA IRAN Uruguai LETONIA UNGARIA/OLANDA ROMÂNIA COLUMBIA IRAK Liberia LIECHTENSTEIN. Argentina FILIPINE FRANTA/GERMANIA Republica GUATEMALA ABCD ABCD OLANDA GERMANIA UNGARIA ELVETIA ITALIA GRECIA INDIA CEHIA AUSTRIA SLOVENIA CROATIA NORVEGIA FRANTA AUSTRALIA ISRAEL EGYPT SLOVACIA FINLANDA IORDANIA IRLANDA DANEMARCA BELGIA SUEDIA CIPRU SPANIA UK S.U.A. TURCIA EMIR. ARABE UNITE REP. MOLDOVA ROMANIA/S.U.A. BULGARIA LUXEMBOURG ISLANDA JAPONIA LUXEMBURG POLONIA CANADA PORTUGALIA SERBIA SI MUNTENEGRU INDIA/ROMANIA BELGIA/ROMANIA MACEDONIA SLOVENIA/ROMANIA SERBIA ROMANIA U.K. MONACO YUGOSLAVIA ROMANIA/ITALIA COREEA DE NORD EMIR. ARABE ROMANIA/GERMANIA GERMANIA/ROMANIA ELVETIA/ROMANIA TURCIA/ROMANIA GRECIA/ROMANIA MALTA ROMANIA/CANADA ANGLIA REPUBLICA CEHA BERMUDA MEXIC ALBANIA ARMENIA MAREA BRITANIE AZERBAIDJAN BOSNIAHERTEGOVINA CHINA Jamaica CUBA Brazilia R06ROMANIA FARA TARA LIBAN LEK PHARMACEUTICALS D.D. LIBIA Republica Nepal MAROC REPUBLICA SLOVACA PAKISTAN PERU KOREEA DE NORD SIRIA LITUANIA RUSIA(FED) TUNISIA UKRAINA NIGERIA CUTIE X 10 BLIST. PV2 Kenia Afghanistan test MAREA BRITANIE Estonia SUDAN

Date trimitere Serie trimitere Serii... Data trimitere ... Numar trimitere Tip trimitere CLINIC LABORATOR INTERNARE Diagnostic prezumptiv* Specialitate* Diagnostic Autocompetare

Investigatii Nr Descriere Cantitate Total compensat: Total pret maxim:

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