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武汉市职工住院医疗互助给付申请书

发布时间:2017-07-18     下载附件

彩经网 DAILIDANWEIMINGCHENG:WUHANGUOYOUZICHANJINGYINGGONGSIGONGHUI

申请给付时请提供以下材料:

彩经网 1、《WUHANSHIZHIGONGZHUYUANYILIAOHUZHUJIFUSHENQINGSHU》;2、CANJIARENSHENFENZHENGYUANJIANHEFUYINJIAN、YIBAOKAYUANJIANHEFUYINJIAN;RUCANJIARENYIJINGSHENGU,HAIXUTIGONGYOUGONGANBUMENCHUJUDEHUJIZHUXIAOZHENGMINGFUYINJIAN、ZHIDINGSHOUYIRENHUOFADINGSHOUYIRENDEZHENGMINGCAILIAOJISHENFENZHENGYUANJIANHEFUYINJIAN;3、YIBAODINGDIANYIYUANHUOBENDIYIBAOBUMENCHUJUDEZHUYUANYILIAOSHOUFEISHOUJU(FAPIAO)、YILIAOFEIYONGJIESUANQINGDANDENGYOUXIAOPIAOJUDEYUANJIAN;4、JINGYIYUANGAIZHANGDECHUYUANXIAOJIEFUYINJIAN;5、SHIZHIGONGYILIAOHUZHUBANGONGSHIRENWEIBIXUTIGONGDEQITAXIANGGUANCAILIAO;6、WUBIZAICHUYUANHOU90TIANYINEIXIANGHUZHUBANTIJIAOSHANGSHUCAILIAO。

注:1、该表格红色部分为固定格式,请不要修改。2、“参加人编号”在“WH”后面填写医保卡号即可。

★HUZHUBANDIANHUA:

JIANGANBANSHICHU:82864586   JIANGHANBANSHICHU:85834930  QIAOKOUBANSHICHU:83801151

彩经网 HANYANGBANSHICHU:84595991   WUCHANGBANSHICHU:88910652   QINGSHANBANSHICHU:68865259

HONGSHANBANSHICHU:87678101   HANNANBANSHICHU:84851462  DONGXIHUBANSHICHU:83897160

CAIDIANBANSHICHU:84942268   JIANGXIABANSHICHU:81825016  HUANGPOBANSHICHU:85932030

XINZHOUBANSHICHU:89353950

 

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027-82824058