
Appendix 2.2: Receipt

Appendix 2.3: List of outpatients requesting payment

Appendix 2.4. Application form for medical examination upon request

Appendix 2.5. Receipt for medical examination upon request

Appendix 2.6: Cash book
Unit: Hanoi Dermatology HospitalModel number: S11-H
(Issued under Circular No.
QHNS Code: 1059048
107/2017/TT-BTC
October 10, 2017 of the Ministry of Finance)
CASH BOOK
2021
Account: 1111 - Vietnamese currency
Date
record
Date of document | Document number | Interpretation | Amount | Note | |||
Collect | Spend | Existing | |||||
A | B | C | D | 1 | 2 | 3 | E |
Beginning balance of January | 367571225 | ||||||
04/01/2021 | 04/01/2021 | PT0001 | Collect money from hospital pharmacy daily 01/01/2021 | 25215746 | 392786971 | ||
04/01/2021 | 04/01/2021 | PT0002 | Collect money from hospital pharmacy daily 02/01/2021 | 79451272 | 472238243 | ||
04/01/2021 | 04/01/2021 | PT0003 | Collect money from hospital pharmacy daily 03/01/2021 | 65956893 | 538195136 | ||
04/01/2021 | 04/01/2021 | PT0004 | Collect medical examination fee on January 4, 2021 | 69000 | 538264136 | ||
04/01/2021 | 04/01/2021 | PT0005 | Collect examination fee according to CKI's request daily 04/01/2021 | 10000000 | 548264136 | ||
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04/01/2021
04/01/2021 | PT0006 | Collect examination fee according to CKII request on day 04/01/2021 | 9000000 | 557264136 | |||
04/01/2021 | 04/01/2021 | PT0007 | Collect examination fee according to doctor's request 04/01/2021 | 12400000 | 569664136 | ||
04/01/2021 | 04/01/2021 | PT0008 | Collect examination fee upon request Associate Professor date 04/01/2021 | 3750000 | 573414136 | ||
04/01/2021 | 04/01/2021 | PT0009 | Collect examination fee upon appointment request over the phone January 4, 2021 | 200000 | 573614136 | ||
04/01/2021 | 04/01/2021 | PT0010 | Collect medical service fees on January 4, 2021 | 83983000 | 657597136 | ||
04/01/2021 | 04/01/2021 | PT0011 | Collect money from hospital pharmacy daily 04/01/2021 | 177363543 | 834960679 | ||
04/01/2021 | 04/01/2021 | PC001 | Support for leprosy patients in Quoc Oai on the occasion of New Year 2021 | 6300000 | 828660679 | ||
04/01/2021 | 04/01/2021 | PC002 | Support living expenses for inpatients Staying at the facility for 3 months 01/2021 | 31500000 | 797160679 | ||
05/01/2021 | 05/01/2021 | PT0012 | Collect medical examination fee on January 5, 2021 | 207000 | 797367679 | ||
05/01/2021 | 05/01/2021 | PT0013 | Collect examination fee according to CKI's request daily 05/01/2021 | 8000000 | 805367679 | ||
05/01/2021 | 05/01/2021 | PT0014 | Collect examination fee according to CKII request on day 05/01/2021 | 12150000 | 817517679 | ||
05/01/2021 | 05/01/2021 | PT0015 | Collect examination fee according to doctor's request 05/01/2021 | 7800000 | 825317679 | ||
05/01/2021 | 05/01/2021 | PT0016 | Collect examination fee upon request Associate Professor date 05/01/2021 | 4750000 | 830067679 | ||
05/01/2021 | 05/01/2021 | PT0017 | Collect medical service fees on January 5, 2021 | 80038000 | 910105679 | ||
05/01/2021 | 05/01/2021 | PT0018 | Collect money from hospital pharmacy daily 05/01/2021 | 162056947 | 1072162626 | ||
06/01/2021 | 06/01/2021 | PT0019 | Collect medical examination fee on January 6, 2021 | 34500 | 12197126 |






