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<div id="print-content">
<h3 style="text-align: center;">基本登记信息</h3>
<table class="tableTopBorder_2">
<tbody>
<tr>
<td>
<span>姓名:</span>
<span>张三</span>
</td>
<td>
<span>性别:</span>
<span>男</span>
</td>
<td>
<span>国籍:</span>
<span>中国</span>
</td>
<td>
<span>名族:</span>
<span>维吾尔族</span>
</td>
</tr>
<tr>
<td>
<span>生日:</span>
<span>2019-08-08</span>
</td>
<td>
<span>社保类型:</span>
<span>城镇灵活就业社会保险</span>
</td>
<td>
<span>血型:</span>
<span>AB型</span>
</td>
<td>
<span>生活方式:</span>
<span>与老伴同居</span>
</td>
</tr>
<tr>
<td>
<span>婚姻状况:</span>
<span>未婚</span>
</td>
<td>
<span>老人爱好:</span>
<span>吃饭睡觉打豆豆</span>
</td>
<td>
<span>紧急号码和老人关系:</span>
<span>父子</span>
</td>
<td>
<span>紧急联系人:</span>
<span>李四</span>
</td>
</tr>
<tr>
<td>
<span>出生日期:</span>
<span>2019-01-02</span>
</td>
<td>
<span>学历:</span>
<span>研究生以上学历</span>
</td>
<td>
<span>籍贯:</span>
<span>北京市</span>
</td>
<td>
<span>紧急号码:</span>
<span>16666666666</span>
</td>
</tr>
<tr>
<td>
<span>政治面貌:</span>
<span>群众</span>
</td>
<td>
<span>职业:</span>
<span>ADC射手</span>
</td>
<td>
<span>手机号:</span>
<span>18888888889</span>
</td>
</tr>
<tr>
<td>
<span>社保卡号:</span>
<span>6224785698542556855</span>
</td>
<td>
<span>身份证号:</span>
<span>135524455986524441</span>
</td>
</tr>
<tr>
<td>
<span>户口地址:</span>
<span>北京市石景山区生命科学园</span>
</td>
<td>
<span>家庭住址:</span>
<span>北京市石景山区生命科学园D区1号楼2445</span>
</td>
</tr>
<tr>
</tr>
<tr>
<td>
<span>入住人病史介绍:</span>
<span>饮用矿泉水啥啥啥</span>
</td>
<td>
<span>入住人服药情况:</span>
<span>爱上大会的卡号贷款哈师大考好点</span>
</td>
</tr>
</tbody>
</table>
<div class="pageBreak"></div>
<br />
<div class="header clear"></div>
<!--步骤一的结束标志-->
<h3 style="text-align: center;">家属信息登记</h3>
<table class="tableTopBorder_3">
<thead>
<tr>
<th>姓名</th>
<th>性别</th>
<th>联系电话</th>
<th>联系地址</th>
<th>工作单位</th>
<th>与老人关系</th>
<th>是否监护人</th>
</tr>
</thead>
<tbody>
<tr>
<td>张三</td>
<td>男</td>
<td>18888888888</td>
<td>北京市石景山苹果园小区</td>
<td>太极大厦2楼</td>
<td>父子</td>
<td>是</td>
</tr>
<tr>
<td>李四</td>
<td>女</td>
<td>166666666665</td>
<td>北京市石景山苹果园小区</td>
<td>太极大厦2楼</td>
<td>父子</td>
<td>是</td>
</tr>
</tbody>
</table>
<div class="pageBreak"></div>
<br />
<div class="header clear"></div>
<!--步骤二的结束标志-->
<h3 style="text-align: center;">健康信息登记</h3>
<table class="tableTopBorder_3">
<tbody>
<tr>
<td>
<span>身高:</span>
<span>18cm</span>
</td>
<td>
<span>体重:</span>
<span>18公斤</span>
</td>
<td>
<span>体温:</span>
<span>18°C</span>
</td>
</tr>
<tr>
<td>
<span>体检报告编号:</span>
<span>111111111111111</span>
</td>
<td>
<span>老人区域分类:</span>
<span>自理区</span>
</td>
<td>
<span>接收否:</span>
<span>接收</span>
</td>
</tr>
<tr>
<td>
<span>呼吸:</span>
<span>1000次/分</span>
</td>
<td>
<span>脉搏:</span>
<span>500次/分</span>
</td>
<td>
<span>血压:</span>
<span>2000毫米汞柱</span>
</td>
</tr>
<tr>
<td>
<span>营养状况:</span>
<span>中等</span>
</td>
<td>
<span>其他:</span>
<span>胃病难受</span>
</td>
<td></td>
</tr>
<tr>
<td>
<span>睡眠情况:</span>
<span>自认入睡</span>
</td>
<td>
<span>药物名称:</span>
<span>阿莫西林</span>
</td>
<td>
<span>排便情况:</span>
<span>正常</span>
</td>
</tr>
<tr>
<td>
<span>饮食情况:</span>
<span>流食</span>
</td>
<td>
<span>食欲:</span>
<span>好</span>
</td>
<td>
<span>管络情况:</span>
<span>人工通气</span>
</td>
</tr>
<tr>
<td>
<span>目前治疗情况:</span>
<span>有</span>
</td>
<td>
<span>入院方式:</span>
<span>平车</span>
</td>
<td>
<span>既往史:</span>
<span>高血压、脑出血、糖尿病、高血压、脑出血、糖尿病</span>
</td>
</tr>
<tr>
<td>
<span>过敏史:</span>
<span>不详</span>
</td>
<td>
<span>食物名称:</span>
<span>鱼香肉丝盖饭</span>
</td>
<td>
<span>药品:</span>
<span>感冒胶囊</span>
</td>
</tr>
<tr>
<td>
<span>家属提供辅助检查资料:</span>
<span>有</span>
</td>
<td>
<span>长者健康类型:</span>
<span>半失能</span>
</td>
<td>
<span>行走:</span>
<span>步态不稳</span>
</td>
</tr>
<tr>
<td>
<span>排泄能力:</span>
<span>丧失功能</span>
</td>
<td>
<span>用餐:</span>
<span>部分帮助</span>
</td>
<td>
<span>洗澡:</span>
<span>部分帮助</span>
</td>
</tr>
<tr>
<td>
<span>穿脱衣:</span>
<span>自理</span>
</td>
<td>
<span>上下床:</span>
<span>完全帮助</span>
</td>
<td>
<span>如厕:</span>
<span>部分帮助</span>
</td>
</tr>
<tr>
<td>
<span>思维能力:</span>
<span>正常</span>
</td>
<td>
<span>语言表达能力:</span>
<span>轻度障碍</span>
</td>
<td>
<span>上下肢活动能力:</span>
<span>中度障碍</span>
</td>
</tr>
</tbody>
</table>
<div class="pageBreak"></div>
<br />
<div class="header clear"></div>
<!--步骤三的结束标志-->
<h3 style="text-align: center;">护理任务设置</h3>
<table class="tableTopBorder_3">
<tbody>
<tr>
<td>
<span>护理级别:</span>
<span>高级</span>
</td>
<td>
<span>级别说明:</span>
<span>xxxxxx</span>
</td>
<td>
<span>级别费用:</span>
<span>5000元/月</span>
</td>
</tr>
<tr>
<td>
<span>私人定制费用:</span>
<span>5000元/月</span>
</td>
<td>
<span>护理总费用:</span>
<span>8000元/月</span>
</td>
<td></td>
</tr>
</tbody>
</table>
<div class="pageBreak"></div>
<br />
<div class="header clear"></div>
<!--步骤四的结束标志-->
<h3 style="text-align: center;">餐饮床位选择</h3>
<table class="tableTopBorder_3">
<tbody>
<tr>
<td>
<span>床号:</span>
<span>浩顺一号楼2015床</span>
</td>
<td>
<span>套餐费用:</span>
<span>5000元/月</span>
</td>
<td>
<span>套餐详情:</span>
<span>这是一个鱼香肉丝盖饭</span>
</td>
</tr>
<tr>
<td>
<span>是否包房:</span>
<span>是</span>
</td>
<td>
<span>费用:</span>
<span>8000元/月</span>
</td>
<td>
<span>备注(信息):</span>
<span>这是给1号床的病人食用的</span>
</td>
</tr>
<tr>
<td>
<span>床位:</span>
<span>A床位</span>
</td>
<td>
<span>床位描述:</span>
<span>这是给一位警察的床位</span>
</td>
<td>
<span>床位类型:</span>
<span>一级床位</span>
</td>
</tr>
</tbody>
</table>
<div class="pageBreak"></div>
<br />
<div class="header clear"></div>
<!--步骤五的结束标志-->
<h3 style="text-align: center;">物品领用</h3>
<table class="tableTopBorder_3">
<thead>
<tr>
<th>物品名称</th>
<th>单位</th>
<th>数量(个)</th>
<th>单价(元)</th>
<th>金额(总)</th>
<th>备注</th>
</tr>
</thead>
<tbody>
<tr>
<td>
<span>纸篓</span>
</td>
<td>
<span>A单位</span>
</td>
<td>
<span>50</span>
</td>
<td>
<span>50</span>
</td>
<td>
<span>50</span>
</td>
<td>
<span>住户好吃懒惰</span>
</td>
</tr>
</tbody>
</table>
<div class="pageBreak"></div>
<br />
<div class="header clear"></div>
<!--步骤六的结束标志-->
<h3 style="text-align: center;">入院缴费</h3>
<table class="tableTopBorder_3">
<thead>
<tr>
<th>入住月收费用类别</th>
<th>收费标准(元)</th>
<th>本月应收(元)</th>
<th>备注</th>
</tr>
</thead>
<tbody>
<tr>
<td>
<span>床位费:</span>
</td>
<td>
<span>100</span>
</td>
<td>
<span>2000</span>
</td>
<td></td>
</tr>
<tr>
<td>
<span>护理费:</span>
</td>
<td>
<span>200</span>
</td>
<td>
<span>3000</span>
</td>
<td></td>
</tr>
<tr>
<td>
<span>订制护理费:</span>
</td>
<td>
<span>300</span>
</td>
<td>
<span>4000</span>
</td>
<td></td>
</tr>
<tr>
<td>
<span>物品领用表:</span>
</td>
<td>
<span></span>
</td>
<td>
<span>5000</span>
</td>
<td></td>
</tr>
<tr>
<td>
<span>餐饮费</span>
</td>
<td>0</td>
<td>
<span>应收月入住费</span>
<span>5000</span>
</td>
<td></td>
</tr>
</tbody>
</table>
<div class="resultTotalGuding">
<h3 style="text-align: center;">固定</h3>
<table class="tableTopBorder_3">
<tbody>
<tr>
<td>
<span>夜壶:</span>
<span>5000</span>个
</td>
<td>
<span>烟袋锅:</span>
<span>2000</span>个
</td>
<td>
<span>水壶:</span>
<span>1000</span>个
</td>
</tr>
</tbody>
</table>
</div>
<div class="resultTotalKexuan">
<h3 style="text-align: center;">可选</h3>
<table class="tableTopBorder_3">
<tbody>
<tr>
<td>
<span>早餐套餐:</span>
<span>5000</span>元
</td>
<td>
<span>中餐套餐:</span>
<span>2000</span>元
</td>
<td>
<span>晚餐套餐:</span>
<span>1000</span>元
</td>
</tr>
</tbody>
</table>
</div>
<div class="resultTotalMoney">
<h3 style="text-align: center;">合计费用</h3>
<table class="tableTopBorder_3">
<tbody>
<tr>
<td>
<span>入住押金:</span>
<span>5000</span>元
</td>
<td>
<span>备用金:</span>
<span>2000</span>元
</td>
<td>
<span>实交费用:</span>
<span>1000</span>元
</td>
</tr>
<tr>
<td>
<span>付款方式</span>
<span>微信支付</span>
</td>
<td></td>
<td></td>
</tr>
</tbody>
</table>
</div>
</div>
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