X100 - Ændring af part/aktør
SED API version: 0.16.2 build 2
Model version: 4.2.0
Sagens sammenhæng
[ SC ]
Person, baggrund
*
[ CC ]
Arbejdsgiver, baggrund
*
[ CC ]
Baggrund for refusion
*
[ SC ]
Efternavn(e)
*
[ BDT ]
{{metaSection.familyName.$$error}}
{{metaSection.familyName.$$warning}}
Fornavn(e)
*
[ BDT ]
{{metaSection.forename.$$error}}
{{metaSection.forename.$$warning}}
Fødselsdato
*
[ BDT ]
{{metaSection.dateBirth.$$error}}
{{metaSection.dateBirth.$$warning}}
Køn
*
{{option.name}}
[ ENUM ]
{{metaSection.sex.$$error}}
{{metaSection.sex.$$warning}}
Navn
*
[ CDT ]
{{metaSection.name.$$error}}
{{metaSection.name.$$warning}}
Identifikationsnumre
[ CC ]
Identifikationsnummer
[ CC ]
Nummer
*
[ CDT ]
{{metaSection.number.$$error}}
{{metaSection.number.$$warning}}
Type
*
{{option.name}}
[ ENUM ]
{{metaSection.type.$$error}}
{{metaSection.type.$$warning}}
Adresse
[ CC ]
Gade
[ CDT ]
{{metaSection.street.$$error}}
{{metaSection.street.$$warning}}
Navn på bygning
[ CDT ]
{{metaSection.buildingName.$$error}}
{{metaSection.buildingName.$$warning}}
By
*
[ CDT ]
{{metaSection.town.$$error}}
{{metaSection.town.$$warning}}
Postnummer
[ CDT ]
{{metaSection.postalCode.$$error}}
{{metaSection.postalCode.$$warning}}
Region
[ CDT ]
{{metaSection.region.$$error}}
{{metaSection.region.$$warning}}
Land
*
{{$select.selected[ 'name']}}
[ ENUM ]
{{metaSection.country.$$error}}
{{metaSection.country.$$warning}}
ID for refusionsanmodning
*
[ BDT ]
{{metaSection.reimbursementRequestID.$$error}}
{{metaSection.reimbursementRequestID.$$warning}}
Samlet antal individuelle krav
*
[ BDT ]
{{metaSection.totalNumberIndividualClaims.$$error}}
{{metaSection.totalNumberIndividualClaims.$$warning}}
Ændring af part/aktør
*
[ SED ]
Tilføj part/aktør
*
[ CC ]
Institutions-ID
*
[ BDT ]
{{metaSection.institutionID.$$error}}
{{metaSection.institutionID.$$warning}}
Institutionens navn
*
[ CDT ]
{{metaSection.institutionName.$$error}}
{{metaSection.institutionName.$$warning}}
Fjern part/aktør
*
[ CC ]
Institutions-ID
*
[ BDT ]
{{metaSection.institutionID.$$error}}
{{metaSection.institutionID.$$warning}}
Institutionens navn
*
[ CDT ]
{{metaSection.institutionName.$$error}}
{{metaSection.institutionName.$$warning}}
Begrundelse
*
{{option.name}}
[ ENUM ]
{{metaSection.reason.$$error}}
{{metaSection.reason.$$warning}}
Hvis "99 - andet" er valgt, anføres flere oplysninger
[ CDT ]
{{metaSection.pleaseProvideMoreDetailsIf99OtherSelected.$$error}}
{{metaSection.pleaseProvideMoreDetailsIf99OtherSelected.$$warning}}