How to write a Medical Expense Receipt Sample? Download this Medical Expense Receipt Sample template that will perfectly suit your needs.
Our collection of online health templates aims to make life easier for you. Our site is updated every day with new health and healthcare templates. By providing you this health Medical Expense Receipt Sample template, we hope you can save precious time, cost and efforts and it will help you to reach the next level of success in your life, studies or work!
Home medical care Insurance points Patient liability ¥ ¥ Examinations ¥ ¥ Diagnostic imaging Medication ¥ Injections Rehabilitation Insurance points Patient liability ¥ ¥ Specialized psychiatric treatment ¥ ¥ Medical treatment Surgery ¥ Blood transfusion Anesthesia Insurance points Patient liability ¥ ¥ Radiotherapy ¥ ¥ Dental crown restoration / Prosthodontics Pathological diagnosis ¥ Prescriptions SUBTOTAL Insurance points Patient liability ¥ ¥ Dietary therapy Patient liability ¥ ¥ ¥ Documentation ¥ Delivery charges ¥ ¥ Special or specified medical care Extra room charges ¥ ¥ Others Patient liability SUBTOTAL ¥ ¥ Comments： Sales tax TOTAL RECEIVED Subtotal to be taxed ¥ Tax ¥ ¥ 医療費領収書 ： 2014 年３月初版.
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