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其他相關資料申請

「病歷摘要」、「檢查報告影本」

【不須掛號】為保障病人權益與隱私,申請資料請備妥相關證件:

1.本人申請:身分證件正本。

2.由代理人申請:病人身分證件正本、代理人身分證件正本、病人之委託同意書。

3.未成年人(未滿18歲)之資料需由法定代理人申請:法定代理人身分證件正本、法定代理人與病人之關係證明文件(戶口名簿或病人身分證件正本),如委託他人代為辦理應備妥法定代理人之委託同意書、代理人身分證件正本。

4.往生者資料之申請:具繼承者之身分證件正本、與病人之關係證明文件、病人除戶證明(戶籍謄本)

◎受理地點:至本院申辦櫃台提出申請(分機11604)

Written by 網站○ Created: Friday, 12 June 2020 16:24
COM_CONTENT_MODIFIED_BY Last Updated: Tuesday, 15 August 2023 09:17

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