Reimbursement Full Acceptance

SED API version: 0.15.2 build 3
Model version: 4.1.0

1. Local case numbers [ CC ]

1.1. Local Case Number [ CC ]

1.1.1. Country *

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1.1.2. Case number *

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1.1.3. Institution [ CC ]

1.1.3.1. Institution ID *

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1.1.3.2. Institution Name *

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1.1.Local Case Number

2. Reimbursement full acceptance * [ SED ]

2.1. Reimbursement request ID *

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