SS3
SD17
SW816
SL1300,30,C
SM0,21

BD11,11,802,15,O
BD11,11,15,1245,O
BD798,11,802,1245,O
BD802,1241,15,1245,O
T242,49,a,2,2,0,0,N,B,'약제비 계산서.영수증'
BD14,114,800,118,O
BD303,118,307,192,O
T50,136,a,1,2,0,0,N,B,'영수증 번호(연월-일련번호)'
BD14,189,800,193,O
BD202,194,204,354,O
BD398,194,400,964,O
BD600,194,602,354,O
T74,215,a,1,2,0,0,N,B,'환자성명'
T264,215,a,1,2,0,0,N,B,'조제일자'
T463,215,a,1,2,0,0,N,B,'투약일수'
T631,215,a,1,2,0,0,N,B,'야간(공휴일) 조제 '
BD14,266,800,268,O
T646,294,a,1,2,0,0,N,B,'야간'
T724,294,a,1,2,0,0,N,B,'공휴일'
T221,298,2,1,1,0,0,N,N,'2003.08.07'
BD627,302,638,304,O
BD627,302,629,318,O
BD636,302,638,318,O
BD638,316,629,318,O
BD699,302,710,304,O
BD699,302,701,318,O
BD708,302,710,318,O
BD710,316,701,318,O
BD628,304,639,310,O
BD628,304,634,318,O
BD633,304,639,318,O
BD639,312,634,318,O
BD14,349,800,353,O
T142,376,a,1,2,0,0,N,B,'항          목'
T541,378,a,1,2,0,0,N,B,'금          액'
BD13,429,799,431,O
T133,455,a,1,2,0,0,N,B,'약제비 총액(1+2+3)'
BD14,506,800,508,O
T132,529,a,1,2,0,0,N,B,'본 인 부 담 금 (1)'
BD14,585,800,587,O
T119,610,a,1,2,0,0,N,B,'보 험 자 부 담 금 (2)'
T97,685,a,1,2,0,0,N,B,'비급여 및 전액본인부담 (3)'
BD14,740,800,744,O
T138,762,a,1,2,0,0,N,B,'총수납금액(1+3)'
BD14,818,800,822,O
BD200,820,202,964,O
BD600,820,602,964,O
T465,842,a,1,2,0,0,N,B,'상     호'
T655,842,a,1,2,0,0,N,B,'한 국 약 국'
T42,843,a,1,2,0,0,N,B,'사업자등록번호'
T215,846,2,1,1,0,0,N,N,'123-123456'
BD14,889,800,891,O
T465,906,a,1,2,0,0,N,B,'성     명'
T646,908,a,1,2,0,0,N,B,'손 오 공'
BD748,908,781,910,O
BD748,908,750,942,O
BD779,908,781,942,O
BD781,940,750,942,O
T50,910,a,1,2,0,0,N,B,'사업장 소재지'
T239,910,a,1,2,0,0,N,B,'서울 청담동'
T751,914,b,1,1,0,0,N,B,'인'
BD14,962,800,964,O
T330,980,a,1,2,0,0,N,B,'2003년 08월 07일'
BD14,1034,800,1036,O
T29,1050,a,1,2,0,0,N,B,'* 이 계산서.영수증은 소득세법상 의료비 공제신청에 필요합니다.'
T30,1098,a,1,2,0,0,N,B,'* 이 계산서.영수증에 대한 세부내역을 요구할 수 있습니다.'
T30,1143,a,1,2,0,0,N,B,'* 전액본인부담금이란 국민건강보험법 시행규칙 별표 5의 규정에 의한 요양급여'
T46,1186,a,1,2,0,0,N,B,'비용의 본인전액부담항목 비용을 말합니다.'
BD14,658,800,660,O
T486,291,3,1,1,0,0,N,N,'3'
T675,682,3,1,1,0,0,N,N,'3,000'
T675,606,3,1,1,0,0,N,N,'7,000'
T80,293,a,1,2,0,0,N,B,'홍길동'
T406,138,3,1,1,0,0,N,N,'20030807-0000001'
T675,530,3,1,1,0,0,N,N,'3,000'
T675,764,3,1,1,0,0,N,N,'6,000'
T656,451,3,1,1,0,0,N,N,'13,000'

T20,1250,a,1,1,0,0,N,B,'별지제8호서식                                     100 mm X 150 mm(보존용지(2종) 70 g/m2)'

P1