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Taoyuan Armed Forces General Hospital
Last Update: 2007-07-16   iconDownloadiconSitemap
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iconNow: Home > Service > Download > Affidavit
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Last Update: 2007-07-16
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Application l Certificate l Letter of Consent
Affidavit l Others


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iconAffidavit


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Blank BlankNo. Title Download
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Blank 1. General Patient Self-Paid Hospitalization Affidavit General Patient Self-Paid Hospitalization Affidavit(open the new windows)
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Blank 2. Voluntary Discharge Affidavit Voluntary Discharge Affidavit(open the new windows)
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Blank 3. Letter of Consent for Self-Payment Letter of Consent for Self-Payment(open the new windows)
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Blank 4. Letter of Guarantee for Hospitalization Letter of Guarantee for Hospitalization(open the new windows)
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Blank 5. Quarantine Notification of Statutory Infectious Disease Quarantine Notification of Statutory Infectious Disease(open the new windows)
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Blank 6. National Health Insurance Patient Room Co-Payment Affidavit National Health Insurance Patient Room Co-Payment Affidavit(open the new windows)
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Blank 7. Letter of Guarantee on Amortization Letter of Guarantee on Amortization(open the new windows)
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Blank 8. Post-Discharge Subsequent Diagnosis Project Post-Discharge Subsequent Diagnosis Project (open the new windows)
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Blank 9. Letter of Pledge for Payments Letter of Pledge for Payments(open the new windows)
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Blank 10. Receipt Receipt(open the new windows)
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Blank 11. Basic Information for the Hospitalized Patient Basic Information for the Hospitalized Patient(open the new windows)
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Blank 12. Hospitalized Patient History Hospitalized Patient History(open the new windows)
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Blank 13. First Visit Registration Form First Visit Registration Form(open the new windows)
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Address: No. 168 Chong Shin Road, Lungtan, Taoyuan County BlankPhone: 03-479-9595
Voice registrations: 03-479-999 BlankManual registration: 03-499-1668BlankComplaint: 03- 4801601
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