Erfassungsbeleg für Notaufnahme
Admission date
date
Admission time
time
Occupational Accident
boolean
Physician referral
integer
Was patient transferred from another hospital?
boolean
Krankenkasse
Health insurance
integer
private health insurance
boolean
Asylum seeker
boolean
Previous hospital admission
boolean
Versicherter / gesetzlicher Vertreter
Name
integer
Date of birth
date
Insurance
integer
Address
integer
Unterschrift