S015 - Teave selle kohta, kas raviteenust osutab liikmesriik, kus viibitakse - plaaniline ravi
Määruse (EÜ) nr 883/2004 artikkel 20; Määruse (EÜ) nr 987/2009 artikkel 26
SED API version: 0.16.2 build 2
Model version: 4.2.0
Isik
*
[ SC ]
Isiku identifitseerimine
*
[ CC ]
Perekonnanimi(-nimed)
*
[ BDT ]
{{metaSection.familyName.$$error}}
{{metaSection.familyName.$$warning}}
Eesnimi (-nimed)
*
[ BDT ]
{{metaSection.forename.$$error}}
{{metaSection.forename.$$warning}}
Sünniaeg
*
[ BDT ]
{{metaSection.dateBirth.$$error}}
{{metaSection.dateBirth.$$warning}}
Sugu
*
{{option.name}}
[ ENUM ]
{{metaSection.sex.$$error}}
{{metaSection.sex.$$warning}}
Sünnijärgne perekonnanimi (-nimed)
[ BDT ]
{{metaSection.familyNameAtBirth.$$error}}
{{metaSection.familyNameAtBirth.$$warning}}
Sünnijärgne eesnimi (-nimed)
[ BDT ]
{{metaSection.forenameAtBirth.$$error}}
{{metaSection.forenameAtBirth.$$warning}}
Isiku PIN igas asutuses
[ CC ]
Isikukood (-id)
*
[ CC ]
Riik
*
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
Personaalne identifitseerimisnumber (PIN)
*
[ BDT ]
{{metaSection.personalIdentificationNumber.$$error}}
{{metaSection.personalIdentificationNumber.$$warning}}
Valdkond
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.sector.$$error}}
{{metaSection.sector.$$warning}}
Asutus
[ CC ]
Asutuse identifitseerimisnumber
*
[ BDT ]
{{metaSection.institutionID.$$error}}
{{metaSection.institutionID.$$warning}}
Asutuse nimi
*
[ CDT ]
{{metaSection.institutionName.$$error}}
{{metaSection.institutionName.$$warning}}
Kui asutuse kohta ei ole esitatud identifitseerimisnumbrit, esitage see nüüd
[ CC ]
Sünnikoht
[ CC ]
Linn
*
[ CDT ]
{{metaSection.town.$$error}}
{{metaSection.town.$$warning}}
Piirkond
[ CDT ]
{{metaSection.region.$$error}}
{{metaSection.region.$$warning}}
Riik
*
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
Isa perekonnanimi sündimisel
[ BDT ]
{{metaSection.fatherFamilyNameAtBirth.$$error}}
{{metaSection.fatherFamilyNameAtBirth.$$warning}}
Isa eesnimi
[ BDT ]
{{metaSection.forenameFather.$$error}}
{{metaSection.forenameFather.$$warning}}
Ema perekonnanimi sündimisel
[ BDT ]
{{metaSection.motherFamilyNameAtBirth.$$error}}
{{metaSection.motherFamilyNameAtBirth.$$warning}}
Ema eesnimi
[ BDT ]
{{metaSection.forenameMother.$$error}}
{{metaSection.forenameMother.$$warning}}
Lisateave isiku kohta
[ SC ]
Rahvus
[ ENUM ]
{{metaSection.nationality.$$error}}
{{metaSection.nationality.$$warning}}
Isiku postiaadress
[ CC ]
Tänav
[ CDT ]
{{metaSection.street.$$error}}
{{metaSection.street.$$warning}}
Hoone nimi
[ CDT ]
{{metaSection.buildingName.$$error}}
{{metaSection.buildingName.$$warning}}
Linn
*
[ CDT ]
{{metaSection.town.$$error}}
{{metaSection.town.$$warning}}
Sihtnumber
[ CDT ]
{{metaSection.postalCode.$$error}}
{{metaSection.postalCode.$$warning}}
Piirkond
[ CDT ]
{{metaSection.region.$$error}}
{{metaSection.region.$$warning}}
Riik
*
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
Teave ravi kohta
*
[ SED ]
Ravi
*
{{option.name}}
[ ENUM ]
{{metaSection.theTreatment.$$error}}
{{metaSection.theTreatment.$$warning}}
Ravi on osaliselt tagatud meie õigusaktidega: põhjendus
[ CDT ]
{{metaSection.treatmentPartiallyProvidedByOurLegislationReason.$$error}}
{{metaSection.treatmentPartiallyProvidedByOurLegislationReason.$$warning}}
Hinnangulised ravikulud
[ CC ]
Summa
*
[ BDT ]
{{metaSection.amount.$$error}}
{{metaSection.amount.$$warning}}
Vääring
*
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.currency.$$error}}
{{metaSection.currency.$$warning}}