Patikslinti turinį

X012 - Patikslinti turinį

SED API version: 0.16.2 build 2
Model version: 4.2.0

Bylos aplinkybės * [ SC ]

Asmens aplinkybės * [ CC ]

Darbdavio aplinkybės * [ CC ]

Kompensavimo aplinkybės * [ SC ]

Pavardė (-ės) *

[ BDT ] {{metaSection.familyName.$$error}} {{metaSection.familyName.$$warning}}

Vardas (-ai) *

[ BDT ] {{metaSection.forename.$$error}} {{metaSection.forename.$$warning}}

Gimimo data *

[ BDT ] {{metaSection.dateBirth.$$error}} {{metaSection.dateBirth.$$warning}}

Lytis *

[ ENUM ] {{metaSection.sex.$$error}} {{metaSection.sex.$$warning}}

Pavadinimas *

[ CDT ] {{metaSection.name.$$error}} {{metaSection.name.$$warning}}

Identifikavimo numeriai [ CC ]

Identifikavimo numeris [ CC ]

Numeris *

[ CDT ] {{metaSection.number.$$error}} {{metaSection.number.$$warning}}

Rūšis *

[ ENUM ] {{metaSection.type.$$error}} {{metaSection.type.$$warning}}

Identifikavimo numeris

Adresas [ CC ]

Gatvė

[ CDT ] {{metaSection.street.$$error}} {{metaSection.street.$$warning}}

Pastato pavadinimas

[ CDT ] {{metaSection.buildingName.$$error}} {{metaSection.buildingName.$$warning}}

Miestas *

[ CDT ] {{metaSection.town.$$error}} {{metaSection.town.$$warning}}

Pašto kodas

[ CDT ] {{metaSection.postalCode.$$error}} {{metaSection.postalCode.$$warning}}

Rajonas

[ CDT ] {{metaSection.region.$$error}} {{metaSection.region.$$warning}}

Šalis *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

Kompensavimo reikalavimo identifikavimo numeris *

[ BDT ] {{metaSection.reimbursementRequestID.$$error}} {{metaSection.reimbursementRequestID.$$warning}}

Bendras atskirų reikalavimų skaičius *

[ BDT ] {{metaSection.totalNumberIndividualClaims.$$error}} {{metaSection.totalNumberIndividualClaims.$$warning}}

Prašome paaiškinti tai * [ SED ]

Paaiškinimas * [ SED ]

Dalis *

[ CDT ] {{metaSection.section.$$error}} {{metaSection.section.$$warning}}

Punktas *

[ CDT ] {{metaSection.item.$$error}} {{metaSection.item.$$warning}}

Priežastis:

[ ENUM ] {{metaSection.reason.$$error}} {{metaSection.reason.$$warning}}

Jei pasirinkta „99 - Kita“, pateikite daugiau informacijos

[ CDT ] {{metaSection.pleaseProvideMoreDetailsIf99OtherSelected.$$error}} {{metaSection.pleaseProvideMoreDetailsIf99OtherSelected.$$warning}}

Paaiškinimas

{{ row.severityMessage }} : {{ row.message }}