住院证格式调整

src/main/java/cn/hnthyy/thmz/controller/CommonController.java

@@ -688,43 +688,43 @@ public class CommonController {
     }
 
 
-    /**
-     * 读取医保电子凭证信息
-     *
-     * @return
-     */
-    @UserLoginToken
-    @RequestMapping(value = "/siReadCard", method = {RequestMethod.GET})
-    public Map<String, Object> siReadCard(@RequestParam String prm) {
-        Map<String, Object> resultMap = new HashMap<>();
-        try {
-            if(StringUtils.isBlank(prm)){
-                resultMap.put("code", -1);
-                resultMap.put("message", "读取医保电子凭证信息失败，参数为空");
-                return resultMap;
-            }
-            resultMap.put("code", 0);
-            resultMap.put("message", "读取医保电子凭证信息成功");
-            Map<String,Object> map=paidForZZService.siReadCard(prm);
-            if(map==null || !Integer.valueOf(200).equals(map.get("code"))){
-                resultMap.put("code", -1);
-                resultMap.put("message", map.get("message"));
-                return resultMap;
-            }
-            Map<String,Object> data=(Map<String,Object>)map.get("data");
-            if(data==null || !Integer.valueOf(0).equals(data.get("code"))){
-                resultMap.put("code", -1);
-                resultMap.put("message", data.get("message"));
-                return resultMap;
-            }
-            resultMap.put("data", data.get("data"));
-            return resultMap;
-        } catch (Exception e) {
-            e.printStackTrace();
-            log.error("读取医保电子凭证信息失败，错误信息{}", e);
-            resultMap.put("code", -1);
-            resultMap.put("message", "读取医保电子凭证信息失败");
-            return resultMap;
-        }
-    }
+//    /**
+//     * 读取医保电子凭证信息
+//     *
+//     * @return
+//     */
+//    @UserLoginToken
+//    @RequestMapping(value = "/siReadCard", method = {RequestMethod.GET})
+//    public Map<String, Object> siReadCard(@RequestParam String prm) {
+//        Map<String, Object> resultMap = new HashMap<>();
+//        try {
+//            if(StringUtils.isBlank(prm)){
+//                resultMap.put("code", -1);
+//                resultMap.put("message", "读取医保电子凭证信息失败，参数为空");
+//                return resultMap;
+//            }
+//            resultMap.put("code", 0);
+//            resultMap.put("message", "读取医保电子凭证信息成功");
+//            Map<String,Object> map=paidForZZService.siReadCard(prm);
+//            if(map==null || !Integer.valueOf(200).equals(map.get("code"))){
+//                resultMap.put("code", -1);
+//                resultMap.put("message", map.get("message"));
+//                return resultMap;
+//            }
+//            Map<String,Object> data=(Map<String,Object>)map.get("data");
+//            if(data==null || !Integer.valueOf(0).equals(data.get("code"))){
+//                resultMap.put("code", -1);
+//                resultMap.put("message", data.get("message"));
+//                return resultMap;
+//            }
+//            resultMap.put("data", data.get("data"));
+//            return resultMap;
+//        } catch (Exception e) {
+//            e.printStackTrace();
+//            log.error("读取医保电子凭证信息失败，错误信息{}", e);
+//            resultMap.put("code", -1);
+//            resultMap.put("message", "读取医保电子凭证信息失败");
+//            return resultMap;
+//        }
+//    }
 }

src/main/java/cn/hnthyy/thmz/controller/mz/ZyReqController.java

@@ -106,10 +106,10 @@ public class ZyReqController {
                     Employee employee= employeeService.queryByUserCode(mzZyReq.getDoctorCode());
                     mzZyReq.setDoctorCode(employee!=null?employee.getEmployeeName():"");
                 }
-                if(mzZyReq.getAdmissStatus()!=null && StringUtils.isNotBlank(mzZyReq.getAdmissStatus())){
-                    CodeNameEntity codeNameEntity= mzZdCommonService.queryAdmissStatusByCode(mzZyReq.getAdmissStatus());
-                    mzZyReq.setAdmissStatus(codeNameEntity!=null?codeNameEntity.getName():"");
-                }
+//                if(mzZyReq.getAdmissStatus()!=null && StringUtils.isNotBlank(mzZyReq.getAdmissStatus())){
+//                    CodeNameEntity codeNameEntity= mzZdCommonService.queryAdmissStatusByCode(mzZyReq.getAdmissStatus());
+//                    mzZyReq.setAdmissStatus(codeNameEntity!=null?codeNameEntity.getName():"");
+//                }
             }
             resultMap.put("code", 0);
             resultMap.put("message", "打印入院通知单成功");

src/main/java/cn/hnthyy/thmz/service/impl/thmz/PaidForZZServiceImpl.java

@@ -85,16 +85,16 @@ public class PaidForZZServiceImpl implements PaidForZZService {
         return null;
     }
 
-    @Override
-    public Map<String, Object> siReadCard(String prm) {
-        try {
-            RestTemplate restTemplate = new RestTemplate();
-            Map<String, Object> resultMap =restTemplate.getForObject(wxPayOrderServiceUrl + "/siReadCard/request?prm="+prm, Map.class);
-            log.info("{}", resultMap);
-            return  resultMap;
-        }catch (Exception e){
-            e.printStackTrace();
-        }
-        return null;
-    }
+//    @Override
+//    public Map<String, Object> siReadCard(String prm) {
+//        try {
+//            RestTemplate restTemplate = new RestTemplate();
+//            Map<String, Object> resultMap =restTemplate.getForObject(wxPayOrderServiceUrl + "/siReadCard/request?prm="+prm, Map.class);
+//            log.info("{}", resultMap);
+//            return  resultMap;
+//        }catch (Exception e){
+//            e.printStackTrace();
+//        }
+//        return null;
+//    }
 }

src/main/java/cn/hnthyy/thmz/service/thmz/PaidForZZService.java

@@ -22,16 +22,16 @@ public interface PaidForZZService {
      */
     Map<String,Object> refundOrder(WxPayOrder wxPayOrder);
 
-    /**
-     * 读取医保电子凭证接口回调
-     * 读身份证：
-     * {code:0, type:"idcard", message:"读取身份证成功。", patNo:"0393849", data:"430624198412073629^黄敏^^女^汉族^19841207^湖南省湘阴县东塘镇小桥村十组10号^湘阴县公安局^2016082920360829^/9j/4AAQSkZJRgABAQEAeAB4AAaSexuG1ZUxXDjfwrDbWHZi57FN"}
-     * 读社保卡：
-     * {code:0, type:"sicard", message:"读取社保卡成功。", patNo:"0407575", data:"430100|430122198506154526|A12361383|430100D156000005243E1265D8599A73|谢盼|0081544436866043010004E2D5|2.00|20150226|20250226|439900900045|00010501202011005091|3|", sign:"HyOH7hTWWHD7WxDmbaDJFY3DS/5DgpnjwIOx6ICRz6lGIlNlEVoJBSgOJmHQ7uk0uF24nHpbAyQeSidowK7Q56L8o9L6"}
-     * 读医保电子凭证：
-     * {code:0, type:"qrcode", message:"读取医保电子凭证成功。", patNo:"0407208", data:{authNo:null, birthday:null, chnlId:null, ecIndexNo:"6D43880DB1749A54CBECC48EA6A6330F", ecQrCode:null, ecToken:"430000ec0vmp77ijkcc33e5d0a00005c3cfd2f", email:null, gender:null, idNo:"432326197506210616", idType:"01", insuOrg:"430923", nationality:null, userName:"曹论文"}, sign:null}
-     * @param prm
-     * @return
-     */
-    Map<String,Object> siReadCard(String prm);
+//    /**
+//     * 读取医保电子凭证接口回调
+//     * 读身份证：
+//     * {code:0, type:"idcard", message:"读取身份证成功。", patNo:"0393849", data:"430624198412073629^黄敏^^女^汉族^19841207^湖南省湘阴县东塘镇小桥村十组10号^湘阴县公安局^2016082920360829^/9j/4AAQSkZJRgABAQEAeAB4AAaSexuG1ZUxXDjfwrDbWHZi57FN"}
+//     * 读社保卡：
+//     * {code:0, type:"sicard", message:"读取社保卡成功。", patNo:"0407575", data:"430100|430122198506154526|A12361383|430100D156000005243E1265D8599A73|谢盼|0081544436866043010004E2D5|2.00|20150226|20250226|439900900045|00010501202011005091|3|", sign:"HyOH7hTWWHD7WxDmbaDJFY3DS/5DgpnjwIOx6ICRz6lGIlNlEVoJBSgOJmHQ7uk0uF24nHpbAyQeSidowK7Q56L8o9L6"}
+//     * 读医保电子凭证：
+//     * {code:0, type:"qrcode", message:"读取医保电子凭证成功。", patNo:"0407208", data:{authNo:null, birthday:null, chnlId:null, ecIndexNo:"6D43880DB1749A54CBECC48EA6A6330F", ecQrCode:null, ecToken:"430000ec0vmp77ijkcc33e5d0a00005c3cfd2f", email:null, gender:null, idNo:"432326197506210616", idType:"01", insuOrg:"430923", nationality:null, userName:"曹论文"}, sign:null}
+//     * @param prm
+//     * @return
+//     */
+//    Map<String,Object> siReadCard(String prm);
 }

src/main/resources/static/js/mz/clinic.js

@@ -7367,6 +7367,24 @@ function printBlRecord(patientId, times, printType) {
     });
 }
 
+/**
+ * 将内容拼接空格，这样才会有下划线
+ * @param mzPatientMi
+ * @param maxLength 最大长度
+ * @returns {*}
+ */
+function formatUnderline(params,maxLength) {
+    var length = 0;
+    if (params == null || params.length == 0) {
+        length = maxLength;
+    } else {
+        length = maxLength - params.length;
+    }
+    for (var i = 0; i < length; i++) {
+        params += " ";
+    }
+    return params;
+}
 
 /**
  * 打印入院通知单
@@ -7410,22 +7428,44 @@ function printZyReq(patientId, printType) {
                 var strStyle = "<style>table{width: 96%;} table,td,th {}</style>";
                 var mzPatientMi = res.mzPatientMi;
                 var mzZyReq = res.mzZyReq;
-                $("#patientIdZyReq").text(mzPatientMi.patientId);
-                $("#patientNameZyReq").text(mzPatientMi.name);
-                $("#patientGenderZyReq").text(mzPatientMi.gender);
-                $("#patientAgeZyReq").text(mzPatientMi.age + "岁");
-                $("#sfzZyReq").text(mzPatientMi.icCardNo);
+                var mzPatientId = formatUnderline(mzPatientMi.patientId,28);
+                $("#patientIdZyReq").text(mzPatientId);
+                var mzPatientMiName = formatUnderline(mzPatientMi.name,16);
+                $("#patientNameZyReq").text(mzPatientMiName);
+                var mzPatientGender = formatUnderline(mzPatientMi.gender,10);
+                $("#patientGenderZyReq").text(mzPatientGender);
+                var mzPatientAge = formatUnderline(mzPatientMi.age+ "岁",18);
+                $("#patientAgeZyReq").text(mzPatientAge);
+                var mzPatientSocialNo = formatUnderline(mzPatientMi.socialNo,61);
+                $("#sfzZyReq").text(mzPatientSocialNo);
                 $("#birthDateZyReq").text(format(mzPatientMi.birthDay, "yyyy-MM-dd"));
-                $("#phoneZyReq").text(mzPatientMi.phoneNo);
+                var mzPatientPhoneNo = formatUnderline(mzPatientMi.phoneNo,72);
+                $("#phoneZyReq").text(mzPatientPhoneNo);
                 $("#responseTypeZyReq").text(mzPatientMi.responseTypeName);
-                $("#addressZyReq").text(mzPatientMi.address);
-                $("#icsTextZyReq").text(mzZyReq.icdText);
-                $("#reqDeptZyReq").text(mzZyReq.reqWard);
-                $("#smallDeptZyReq").text(mzZyReq.smallDept);
-                $("#admissStatusZyReq").text(mzZyReq.admissStatus);
-                $("#visitDateZyReq").text(format(mzZyReq.visitDate, "yyyy-MM-dd HH:mm:ss"));
-                $("#deptCodeZyReq").text(mzZyReq.deptCode);
-                $("#doctorCodeZyReq").text(mzZyReq.doctorCode);
+                var mzPatientMiAddress = formatUnderline(mzPatientMi.address,40);
+                $("#addressZyReq").text(mzPatientMiAddress);
+                if(mzZyReq.icdCode==null || mzZyReq.icdCode=="" || mzZyReq.icdCode.length==0){
+                    $("#icsCodeZyReq").html("&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;");
+                    var mzPatientMiIcdText = formatUnderline(mzZyReq.icdText,31);
+                    $("#icsTextZyReq").text(" "+mzPatientMiIcdText);
+                }else {
+                    var mzPatientMiIcdCode = formatUnderline(mzZyReq.icdCode,31);
+                    $("#icsCodeZyReq").text(mzPatientMiIcdCode);
+                    var mzPatientMiIcdText = formatUnderline(mzZyReq.icdText,30);
+                    $("#icsTextZyReq").text(mzPatientMiIcdText);
+                }
+                var mzZyReqReqWard = formatUnderline(mzZyReq.reqWard,11);
+                $("#reqDeptZyReq").text(mzZyReqReqWard);
+                var mzZyReqSmallDept = formatUnderline(mzZyReq.smallDept,30);
+                $("#smallDeptZyReq").text(mzZyReqSmallDept);
+                //$("#admissStatusZyReq").text(mzZyReq.admissStatus);
+                $("input:checkbox[value='"+mzZyReq.admissStatus+"']").attr('checked','true');
+                var mzZyReqVisitDate = formatUnderline(format(mzZyReq.visitDate, "yyyy-MM-dd HH:mm:ss"),20);
+                $("#visitDateZyReq").text(mzZyReqVisitDate);
+                var mzZyReqDeptCode = formatUnderline(mzZyReq.deptCode,33);
+                $("#deptCodeZyReq").text(mzZyReqDeptCode);
+                var mzZyReqDoctorCode = formatUnderline(mzZyReq.doctorCode,9);
+                $("#doctorCodeZyReq").text(mzZyReqDoctorCode);
                 LODOP.ADD_PRINT_HTM("0mm", "5mm", "140mm", "200mm", strStyle + document.getElementById("mz_zy_req_table").innerHTML);
                 if (printType == 1) {
                     LODOP.PREVIEW();

src/main/resources/static/js/mz/registration.js

@@ -1657,10 +1657,9 @@ function saveBackNo() {
  * 医保电子凭证读卡
  */
 function siReadCard() {
-    var prm="qrcode_"+getUID()+"_01101";
     $.ajax({
         type: "GET",
-        url: '/thmz/siReadCard?prm='+ prm,
+        url: 'http://localhost:8321/readcard/entry?param=qrcode_01101',
         contentType: "application/json;charset=UTF-8",
         dataType: "json",
         headers: {'Accept': 'application/json', 'Authorization': 'Bearer ' + localStorage.getItem("token")},
@@ -1669,11 +1668,13 @@ function siReadCard() {
                 window.location.href = '/thmz/login/view'
                 return;
             }
-            if (res.code == 0) {
-                $('#certificateType').selectpicker('val', res.data.idType);
+            //console.log(res);
+            if (res.code == 200) {
+                var data = JSON.parse(res.data);
+                $('#certificateType').selectpicker('val', data.data.idType);
                 $('#certificateType').selectpicker('refresh');
-                $("#idCard").val(res.data.idNo);
-                $("#userName").val(res.data.userName);
+                $("#idCard").val(data.data.idNo);
+                $("#userName").val(data.data.userName);
                 queryUserInfoBySocialNo();
                 successMesage(res);
             } else {
@@ -1681,7 +1682,7 @@ function siReadCard() {
             }
         }
     });
-    window.open('ReadCard://'+prm, '_self')
+   // window.open('ReadCard://'+prm, '_self')
 }
 
 

src/main/resources/templates/mz/clinic.html

@@ -2081,54 +2081,78 @@
     <div>
         <div>
             <div style="position: relative;">
-                <div style="text-align:center;font-weight: 700;">湖南泰和医院</div>
+                <div style="text-align:center;font-weight: 400;">泰和医院</div>
             </div>
-            <div style="text-align:center;font-weight: 700;">入院通知单</div>
+            <div style="text-align:center;font-weight: 700;font-size: 20px;margin-top: 10px;">住&nbsp;&nbsp;院&nbsp;&nbsp;通&nbsp;&nbsp;知&nbsp;&nbsp;单</div>
             <table class="table table-striped table-bordered"
                    style="margin-top: 10px;border-collapse: separate;border-spacing: 0px 10px;">
                 <tbody style="font-size: 13px;">
                 <tr>
-                    <td>门诊ID： <span id="patientIdZyReq"></span></td>
-                    <td>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;姓名：<span id="patientNameZyReq"></span></td>
-                    <td>性别： <span id="patientGenderZyReq"></span></td>
-                    <td>年龄：<span id="patientAgeZyReq"></span></td>
+                    <td>患者姓名：<span id="patientNameZyReq" style="text-decoration: underline;"></span></td>
+                    <td>性别：<span id="patientGenderZyReq" style="text-decoration: underline;"></span></td>
+                    <td>年龄：<span id="patientAgeZyReq" style="text-decoration: underline;"></span></td>
                 </tr>
                 <tr>
-                    <td>身份证：<span id="sfzZyReq"></span></td>
-                    <td>出生日期： <span id="birthDateZyReq"></span></td>
-                    <td>电话： <span id="phoneZyReq"></span></td>
-                    <td>性质：<span id="responseTypeZyReq"></span></td>
+                    <td colspan="2">身份证号码：<span id="sfzZyReq" style="text-decoration: underline;"></span></td>
+                    <td>门诊编号：<span id="patientIdZyReq" style="text-decoration: underline;"></span></td>
+                    <!--<td>出生日期： <span id="birthDateZyReq"></span></td>-->
+                    <!--<td>电话： <span id="phoneZyReq"></span></td>-->
+                    <!--<td>性质：<span id="responseTypeZyReq"></span></td>-->
                 </tr>
                 <tr>
-                    <td colspan="4">地址：<span id="addressZyReq"></span></td>
+                    <td colspan="3">住&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;址：<span id="addressZyReq" style="text-decoration: underline;"></span></td>
                 </tr>
                 <tr>
-                    <td colspan="4">诊断：<span id="icsTextZyReq"></span></td>
+                    <td colspan="2">联系电话：<span id="phoneZyReq" style="text-decoration: underline;"></span></td>
+                    <td>医疗付费方式：<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
                 </tr>
-                </tbody>
-            </table>
-            <table class="table table-striped table-bordered" style="border-collapse: separate;border-spacing: 0px 10px;margin-top: -10px">
-                <tbody style="font-size: 13px;">
                 <tr>
-                    <td>入院病区：<span id="reqDeptZyReq"></span></td>
-                    <td style="width: 140px;"></td>
-                    <td>入院科室： <span id="smallDeptZyReq"></span></td>
+                    <td colspan="3">初步诊断：</td>
                 </tr>
                 <tr>
-                    <td>入院状态： <span id="admissStatusZyReq"></span></td>
-                    <td style="width: 140px;"></td>
-                    <td>申请科室： <span id="deptCodeZyReq"></span></td>
+                    <td colspan="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1.<span id="icsTextZyReq" style="text-decoration: underline;"></span></td>
+                    <td>疾病编码.<span id="icsCodeZyReq" style="text-decoration: underline;"></span></td>
                 </tr>
                 <tr>
-                    <td>申请医生：<span id="doctorCodeZyReq"></span></td>
-                    <td style="width: 140px;"></td>
-                    <td>申请时间：<span id="visitDateZyReq"></span></td>
+                    <td colspan="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2.<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
+                    <td>疾病编码.<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
                 </tr>
                 <tr>
-                    <td></td>
-                    <td style="width: 140px;"></td>
-                    <td>医师签名：<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span>
-                    </td>
+                    <td colspan="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3.<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
+                    <td>疾病编码.<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
+                </tr>
+                <tr>
+                    <td colspan="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;4.<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
+                    <td>疾病编码.<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
+                </tr>
+                <tr>
+                    <td colspan="2">入住科室：<span id="smallDeptZyReq" style="text-decoration: underline;"></span></td>
+                    <td>入住病区：<span id="reqDeptZyReq" style="text-decoration: underline;"></span></td>
+                </tr>
+                <tr>
+                    <td colspan="3">入院状态：<span>一般<input type="checkbox" name="admissStatusZyReq" value="3"/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;病重<input type="checkbox" name="admissStatusZyReq" value="0"/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;病危<input type="checkbox" name="admissStatusZyReq" value="1"/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;加急<input type="checkbox" name="admissStatusZyReq" value="2"/></span></td>
+                </tr>
+                <tr>
+                    <td colspan="3">抄送方式：<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
+                </tr>
+                </tbody>
+            </table>
+            <table class="table table-striped table-bordered" style="border-collapse: separate;border-spacing: 0px 10px;margin-top: 150px">
+                <tbody style="font-size: 13px;">
+                <!--<tr>-->
+                    <!--<td>入院病区：<span id="reqDeptZyReq"></span></td>-->
+                    <!--<td style="width: 140px;"></td>-->
+                    <!--<td>入院科室： <span id="smallDeptZyReq"></span></td>-->
+                <!--</tr>-->
+                <tr>
+                    <!--<td>入院状态： <span id="admissStatusZyReq"></span></td>-->
+                    <!--<td style="width: 140px;"></td>-->
+                    <td>申请科室： <span id="deptCodeZyReq" style="text-decoration: underline;"></span></td>
+                    <td>申请医生(签字)：<span id="doctorCodeZyReq" style="text-decoration: underline;"></span></td>
+                </tr>
+                <tr>
+                    <td>预缴医疗费：<span style="text-decoration: underline;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></td>
+                    <td>申请日期：<span id="visitDateZyReq" style="text-decoration: underline;"></span></td>
                 </tr>
                 </tbody>
             </table>