Include P12 V2 - HSPAHR93

HSPAHR93.CH

 #DEFINE STR0001 FWI18NLang("HSPAHR93","STR0001",1)
#DEFINE STR0002 FWI18NLang("HSPAHR93","STR0002",2)
#DEFINE STR0003 FWI18NLang("HSPAHR93","STR0003",3)
#DEFINE STR0004 FWI18NLang("HSPAHR93","STR0004",4)
#DEFINE STR0005 FWI18NLang("HSPAHR93","STR0005",5)
#DEFINE STR0006 FWI18NLang("HSPAHR93","STR0006",6)
#DEFINE STR0007 FWI18NLang("HSPAHR93","STR0007",7)
#DEFINE STR0008 FWI18NLang("HSPAHR93","STR0008",8)
#DEFINE STR0009 FWI18NLang("HSPAHR93","STR0009",9)
#DEFINE STR0010 FWI18NLang("HSPAHR93","STR0010",10)
#DEFINE STR0011 FWI18NLang("HSPAHR93","STR0011",11)
#DEFINE STR0012 FWI18NLang("HSPAHR93","STR0012",12)
#DEFINE STR0013 FWI18NLang("HSPAHR93","STR0013",13)
#DEFINE STR0014 FWI18NLang("HSPAHR93","STR0014",14)
#DEFINE STR0015 FWI18NLang("HSPAHR93","STR0015",15)
#DEFINE STR0016 FWI18NLang("HSPAHR93","STR0016",16)
#DEFINE STR0017 FWI18NLang("HSPAHR93","STR0017",17)
#DEFINE STR0018 FWI18NLang("HSPAHR93","STR0018",18)
#DEFINE STR0019 FWI18NLang("HSPAHR93","STR0019",19)
#DEFINE STR0020 FWI18NLang("HSPAHR93","STR0020",20)
#DEFINE STR0021 FWI18NLang("HSPAHR93","STR0021",21)
#DEFINE STR0022 FWI18NLang("HSPAHR93","STR0022",22)
#DEFINE STR0023 FWI18NLang("HSPAHR93","STR0023",23)
#DEFINE STR0024 FWI18NLang("HSPAHR93","STR0024",24)
#DEFINE STR0025 FWI18NLang("HSPAHR93","STR0025",25)
#DEFINE STR0026 FWI18NLang("HSPAHR93","STR0026",26)
#DEFINE STR0027 FWI18NLang("HSPAHR93","STR0027",27)
#DEFINE STR0028 FWI18NLang("HSPAHR93","STR0028",28)
#DEFINE STR0029 FWI18NLang("HSPAHR93","STR0029",29)
#DEFINE STR0030 FWI18NLang("HSPAHR93","STR0030",30)
#DEFINE STR0031 FWI18NLang("HSPAHR93","STR0031",31)
#DEFINE STR0032 FWI18NLang("HSPAHR93","STR0032",32)
#DEFINE STR0033 FWI18NLang("HSPAHR93","STR0033",33)
#DEFINE STR0034 FWI18NLang("HSPAHR93","STR0034",34)
#DEFINE STR0035 FWI18NLang("HSPAHR93","STR0035",35)
#DEFINE STR0036 FWI18NLang("HSPAHR93","STR0036",36)
#DEFINE STR0037 FWI18NLang("HSPAHR93","STR0037",37)
#DEFINE STR0038 FWI18NLang("HSPAHR93","STR0038",38)
#DEFINE STR0039 FWI18NLang("HSPAHR93","STR0039",39)
#DEFINE STR0040 FWI18NLang("HSPAHR93","STR0040",40)
#DEFINE STR0041 FWI18NLang("HSPAHR93","STR0041",41)
#DEFINE STR0042 FWI18NLang("HSPAHR93","STR0042",42)
#DEFINE STR0043 FWI18NLang("HSPAHR93","STR0043",43)
#DEFINE STR0044 FWI18NLang("HSPAHR93","STR0044",44)
#DEFINE STR0045 FWI18NLang("HSPAHR93","STR0045",45)
#DEFINE STR0046 FWI18NLang("HSPAHR93","STR0046",46)
#DEFINE STR0047 FWI18NLang("HSPAHR93","STR0047",47)
#DEFINE STR0048 FWI18NLang("HSPAHR93","STR0048",48)
#DEFINE STR0049 FWI18NLang("HSPAHR93","STR0049",49)
#DEFINE STR0050 FWI18NLang("HSPAHR93","STR0050",50)
#DEFINE STR0051 FWI18NLang("HSPAHR93","STR0051",51)
#DEFINE STR0052 FWI18NLang("HSPAHR93","STR0052",52)
#DEFINE STR0053 FWI18NLang("HSPAHR93","STR0053",53)
#DEFINE STR0054 FWI18NLang("HSPAHR93","STR0054",54)
#DEFINE STR0055 FWI18NLang("HSPAHR93","STR0055",55)
#DEFINE STR0056 FWI18NLang("HSPAHR93","STR0056",56)
#DEFINE STR0057 FWI18NLang("HSPAHR93","STR0057",57)
#DEFINE STR0058 FWI18NLang("HSPAHR93","STR0058",58)
#DEFINE STR0059 FWI18NLang("HSPAHR93","STR0059",59)
#DEFINE STR0060 FWI18NLang("HSPAHR93","STR0060",60)
#DEFINE STR0061 FWI18NLang("HSPAHR93","STR0061",61)
#DEFINE STR0062 FWI18NLang("HSPAHR93","STR0062",62)
#DEFINE STR0063 FWI18NLang("HSPAHR93","STR0063",63)
#DEFINE STR0064 FWI18NLang("HSPAHR93","STR0064",64)
#DEFINE STR0065 FWI18NLang("HSPAHR93","STR0065",65)
#DEFINE STR0066 FWI18NLang("HSPAHR93","STR0066",66)
#DEFINE STR0067 FWI18NLang("HSPAHR93","STR0067",67)
#DEFINE STR0068 FWI18NLang("HSPAHR93","STR0068",68)
#DEFINE STR0069 FWI18NLang("HSPAHR93","STR0069",69)
#DEFINE STR0070 FWI18NLang("HSPAHR93","STR0070",70)
#DEFINE STR0071 FWI18NLang("HSPAHR93","STR0071",71)
#DEFINE STR0072 FWI18NLang("HSPAHR93","STR0072",72)
#DEFINE STR0073 FWI18NLang("HSPAHR93","STR0073",73)
#DEFINE STR0074 FWI18NLang("HSPAHR93","STR0074",74)
#DEFINE STR0075 FWI18NLang("HSPAHR93","STR0075",75)
#DEFINE STR0076 FWI18NLang("HSPAHR93","STR0076",76)
#DEFINE STR0077 FWI18NLang("HSPAHR93","STR0077",77)
#DEFINE STR0078 FWI18NLang("HSPAHR93","STR0078",78)
#DEFINE STR0079 FWI18NLang("HSPAHR93","STR0079",79)
#DEFINE STR0080 FWI18NLang("HSPAHR93","STR0080",80)
#DEFINE STR0081 FWI18NLang("HSPAHR93","STR0081",81)
#DEFINE STR0082 FWI18NLang("HSPAHR93","STR0082",82)
#DEFINE STR0083 FWI18NLang("HSPAHR93","STR0083",83)
#DEFINE STR0084 FWI18NLang("HSPAHR93","STR0084",84)
#DEFINE STR0085 FWI18NLang("HSPAHR93","STR0085",85)
#DEFINE STR0086 FWI18NLang("HSPAHR93","STR0086",86)
#DEFINE STR0087 FWI18NLang("HSPAHR93","STR0087",87)
#DEFINE STR0088 FWI18NLang("HSPAHR93","STR0088",88)
#DEFINE STR0089 FWI18NLang("HSPAHR93","STR0089",89)
#DEFINE STR0090 FWI18NLang("HSPAHR93","STR0090",90)
#DEFINE STR0091 FWI18NLang("HSPAHR93","STR0091",91)
#DEFINE STR0092 FWI18NLang("HSPAHR93","STR0092",92)
#DEFINE STR0093 FWI18NLang("HSPAHR93","STR0093",93)
#DEFINE STR0094 FWI18NLang("HSPAHR93","STR0094",94)
 

HSPAHR93_EN.TRES

 0001#STR0001#ALL#REPORT TO REQUEST AUTHORIZATION FOR HOSPITALIZATION
0002#STR0002#ALL#REPORT TO REQUEST AUTHORIZATION 
0003#STR0003#ALL#FOR HOSPITALIZATION
0004#STR0004#ALL#Identification of Health Care Establishment
0005#STR0005#ALL#Name of Requester Establishment
0006#STR0006#ALL#CNES
0007#STR0007#ALL#Name of Executer Establishment
0008#STR0008#ALL#Patient Identification
0009#STR0009#ALL#Patient Name
0010#STR0010#ALL#Medical record Number
0011#STR0011#ALL#National Health Card (CNS)
0012#STR0012#ALL#Birthday
0013#STR0013#ALL#GENDER
0014#STR0014#ALL#Male
0015#STR0015#ALL#Female
0016#STR0016#ALL#Ethnicity/Color
0017#STR0017#ALL#Mother�s Name 
0018#STR0018#ALL#Long-distance code
0019#STR0019#ALL#Contact Phone
0020#STR0020#ALL#Name of responsible person
0021#STR0021#ALL#Address (street, no., district)
0022#STR0022#ALL#Residence City
0023#STR0023#ALL#Code IBGE City
0024#STR0024#ALL#State
0025#STR0025#ALL#CEP (Zip Code)
0026#STR0026#ALL#HOSPITALIZATION REASON
0027#STR0027#ALL#Main Clinical Symptoms and Signs
0028#STR0028#ALL#Conditions that justify the hospitalization
0029#STR0029#ALL#Main results of Diagnostic Evidence (Results of Examinations)
0030#STR0030#ALL#Initials Diagnosis
0031#STR0031#ALL#ICD 10 Main
0032#STR0032#ALL#ICD 10 Secondary
0033#STR0033#ALL#ICD 10 Causes Associated
0034#STR0034#ALL#PROCEDURE REQUESTED 
0035#STR0035#ALL#Description of Procedure Requested
0036#STR0036#ALL#Procedure Code
0037#STR0037#ALL#Clinic
0038#STR0038#ALL#Hospitalization Characteristic
0039#STR0039#ALL#Document
0040#STR0040#ALL#Document No. (CNS/CPF) of Assistant/Requester Professional
0041#STR0041#ALL#Name of Assistant/Requester Professional
0042#STR0042#ALL#Request Date
0043#STR0043#ALL#Signature and Stamp (No. of Council Registration)
0044#STR0044#ALL#FILL OUT IN CASE OF EXTERNAL CAUSES (ACCIDENT OR VIOLENCE)
0045#STR0045#ALL#CNPJ of Insurance Company 
0046#STR0046#ALL#Ticket Number 
0047#STR0047#ALL#Series 
0048#STR0048#ALL#Company CNPJ 
0049#STR0049#ALL#Company CNAE 
0050#STR0050#ALL#CBOR 
0051#STR0051#ALL#Bond with Social Security 
0052#STR0052#ALL#Authorization 
0053#STR0053#ALL#Name of Authorizer Professional 
0054#STR0054#ALL#Issuer Agency Code
0055#STR0055#ALL#Number of Hospitalization Authorization
0056#STR0056#ALL#Document No. (CNS/CPF) of Authorizer Professional
0057#STR0057#ALL#Signature and Stamp (No. of Council Registration)
0058#STR0058#ALL#REPORT FOR REQUEST/AUTHORIZATION FOR PROCEDURE CHANGE AND SPECIAL PROCEDURE(S)
0059#STR0059#ALL#REQUEST/AUTHORIZATION FOR PROCEDURE CHANGE 
0060#STR0060#ALL#AND SPECIAL PROCEDURE(S)
0061#STR0061#ALL#SHEET
0062#STR0062#ALL#Number of Authorization of Hospitalization (AIH)
0063#STR0063#ALL#PROCEDURE CHANGE
0064#STR0064#ALL#Description of Procedure Requested - Previous
0065#STR0065#ALL#Procedure Code - Previous
0066#STR0066#ALL#Description of Procedure Requested - Change
0067#STR0067#ALL#Procedure Code - Change
0068#STR0068#ALL#REQUEST OF SPECIAL PROCEDURE(S)
0069#STR0069#ALL#Description of Main Procedure
0070#STR0070#ALL#Code of Main Procedure
0071#STR0071#ALL#Request of ICU Daily Rate and/or Companion Daily Rate
0072#STR0072#ALL#Companion Daily Rate 
0073#STR0073#ALL#Type I ICU Daily Rate 
0074#STR0074#ALL#Type II ICU Daily Rate 
0075#STR0075#ALL#Type III ICU Daily Rate 
0076#STR0076#ALL#Description of Special Procedure
0077#STR0077#ALL#Code of Special Procedure
0078#STR0078#ALL#Amount
0079#STR0079#ALL#REQUEST JUSTIFICATION
0080#STR0080#ALL#REQUESTER PROFESSIONAL
0081#STR0081#ALL#Name of Requester Professional
0082#STR0082#ALL#Document No. (CNS/CPF) of Requester Professional
0083#STR0083#ALL#Signature and Stamp (No. of Council Registration)
0084#STR0084#ALL#AUTHORIZATION
0085#STR0085#ALL#Name of Authorizer Professional
0086#STR0086#ALL#REQUEST OF SPECIAL PROCEDURES - CONTINUE
0087#STR0087#ALL#REQUEST JUSTIFICATION (Continuation)
0088#STR0088#ALL#Signature and Stamp (No. of Council Registration) of Requester Professional
0089#STR0089#ALL#Signature and Stamp (No. of Council Registration) of Authorizer Professional
0090#STR0090#ALL#Authorization Date
0091#STR0091#ALL#Attention
0092#STR0092#ALL#SUS Report Validation
0093#STR0093#ALL#Patient cancelled!
0094#STR0094#ALL#Patient has no agreement with SUS!
 

HSPAHR93_ES.TRES

 0001#STR0001#ALL#LAUDO PARA SOLICITUD DE AUTORIZACION DE INTERNACION HOSPITALAR
0002#STR0002#ALL#LAUDO PARA SOLICITUD DE AUTORIZACION 
0003#STR0003#ALL#DE INTERNACION HOSPITALAR
0004#STR0004#ALL#Identificacion del Establecimiento de Salud
0005#STR0005#ALL#Nombre del Establecimiento Solicitante
0006#STR0006#ALL#CNES
0007#STR0007#ALL#Nombre del Establecimiento Ejecutor
0008#STR0008#ALL#Identificacion del Paciente
0009#STR0009#ALL#Nombre del Paciente
0010#STR0010#ALL#N� del Prontuario
0011#STR0011#ALL#Tarjeta Nacional de Salud (CNS)
0012#STR0012#ALL#Fecha de Nacimiento
0013#STR0013#ALL#Sexo
0014#STR0014#ALL#Masc.
0015#STR0015#ALL#Fem.
0016#STR0016#ALL#Raza/Color
0017#STR0017#ALL#Nombre de la Madre 
0018#STR0018#ALL#DDD
0019#STR0019#ALL#Telefono de Contacto
0020#STR0020#ALL#Nombre del Responsable
0021#STR0021#ALL#Direccion (Calle, n�, barrio)
0022#STR0022#ALL#Municipio de Residencia
0023#STR0023#ALL#Cod. IBGE Municipio
0024#STR0024#ALL#Provincia/Departamento
0025#STR0025#ALL#CP:
0026#STR0026#ALL#JUSTIFICATIVA DE LA INTERNACION
0027#STR0027#ALL#Principales Senales y Sintomas Clinicos
0028#STR0028#ALL#Condiciones que Justifican la Internacion
0029#STR0029#ALL#Principales Resultados de Examenes Diagnosticos (Resultados de Examenes Realizados)
0030#STR0030#ALL#Diagnostico Inicial
0031#STR0031#ALL#CID 10 Principal
0032#STR0032#ALL#CID 10 Secundario
0033#STR0033#ALL#CID 10 Causas Asociadas
0034#STR0034#ALL#PROCEDIMIENTO SOLICITADO 
0035#STR0035#ALL#Descripcion del Procedimiento Solicitado
0036#STR0036#ALL#Codigo del Procedimiento
0037#STR0037#ALL#CLINICA
0038#STR0038#ALL#Caracter de la Internacion
0039#STR0039#ALL#Documento:
0040#STR0040#ALL#N� Documento (CNS/CPF) del Profesional Solicitante / Asistente
0041#STR0041#ALL#Nombre del Profesional Solicitante/Asistente
0042#STR0042#ALL#Fecha de la Solicitud
0043#STR0043#ALL#Firma y Sello (N� del Registro del Consejo)
0044#STR0044#ALL#RELLENAR EN CASO DE CAUSAS EXTERNAS (ACCIDENTES O VIOLENCIAS)
0045#STR0045#ALL#CNPJ de la Empresa 
0046#STR0046#ALL#N� del Boleto 
0047#STR0047#ALL#Serie 
0048#STR0048#ALL#CNPJ de la Empresa 
0049#STR0049#ALL#CNAE de la Empresa 
0050#STR0050#ALL#CBOR 
0051#STR0051#ALL#V�nculo con la Seguridad Social 
0052#STR0052#ALL#Autorizacion 
0053#STR0053#ALL#Nombre del Profesional que Autoriza 
0054#STR0054#ALL#Cod. Organo Emisor
0055#STR0055#ALL#N� de la Autorizacion de Internacion Hospitalar
0056#STR0056#ALL#N� Documento (CNS/CPF) del Profesional que Autoriza
0057#STR0057#ALL#Firma y Sello (N� del Registro del Consejo)
0058#STR0058#ALL#LAUDO PARA SOLICITUD/AUTORIZACION DE CAMBIO DE PROCEDIMIENTO Y DE PROCEDIMIENTO (S) ESPECIAL (ES)
0059#STR0059#ALL#LAUDO PARA SOLICITUD/AUTORIZACION DE CAMBIO DE 
0060#STR0060#ALL#PROCEDIMIENTO Y DE PROCEDIMIENTO (S) ESPECIAL (ES)
0061#STR0061#ALL#HOJA
0062#STR0062#ALL#Numero de la Autorizacion de Internacion Hospitalar (AIH)
0063#STR0063#ALL#CAMBIO DE PROCEDIMIENTO
0064#STR0064#ALL#Descripcion del Procedimiento Solicitado - Anterior
0065#STR0065#ALL#Codigo del Procedimiento - Anterior
0066#STR0066#ALL#Descripcion del Procedimiento Solicitado - Cambio
0067#STR0067#ALL#Codigo del Procedimiento - Cambio
0068#STR0068#ALL#SOLICITUD DE PROCEDIMIENTO (S) ESPECIAL (ES)
0069#STR0069#ALL#Descripcion del Procedimiento Principal
0070#STR0070#ALL#Codigo del Procedimiento Principal
0071#STR0071#ALL#Solicitud de Diarias de UTI y/o Diaria de Acompanante
0072#STR0072#ALL#Diaria de Acompanante 
0073#STR0073#ALL#Diaria de UTI Tipo I 
0074#STR0074#ALL#Diaria de UTI Tipo II 
0075#STR0075#ALL#Diaria de UTI Tipo III 
0076#STR0076#ALL#Descripcion del Procedimiento Especial
0077#STR0077#ALL#Codigo del Procedimiento Especial
0078#STR0078#ALL#Cant.
0079#STR0079#ALL#JUSTIFICATIVA DE LA SOLICITUD
0080#STR0080#ALL#PROFESIONAL SOLICITANTE
0081#STR0081#ALL#Nombre del Profesional Solicitante
0082#STR0082#ALL#N� Documento (CNS/CPF) del Profesional Solicitante
0083#STR0083#ALL#Firma y Sello (N� del Registro del Consejo)
0084#STR0084#ALL#Autorizacion
0085#STR0085#ALL#Nombre del Profesional que Autoriza
0086#STR0086#ALL#SOLICITUD DE PROCEDIMIENTO(S) ESPECIAL(ES) - CONTINUACION
0087#STR0087#ALL#JUSTIFICATIVA DE LA SOLICITUD (Continuacion)
0088#STR0088#ALL#Firma y Sello (N� del Registro del Consejo) del Profesional Solicitante
0089#STR0089#ALL#Firma y Sello (N� del Registro del Consejo) del Profesional que Autoriza
0090#STR0090#ALL#Fecha de la Autorizacion
0091#STR0091#ALL#Atencion
0092#STR0092#ALL#Validacion Laudo SUS
0093#STR0093#ALL#�Paciente anulado!
0094#STR0094#ALL#�El paciente no tiene convenio SUS!
 

HSPAHR93_PT-BR.TRES

 0001#STR0001#ALL#LAUDO PARA SOLICITA��O DE AUTORIZA��O DE INTERNA��O HOSPITALAR
0002#STR0002#ALL#LAUDO PARA SOLICITA��O DE AUTORIZA��O 
0003#STR0003#ALL#DE INTERNA��O HOSPITALAR
0004#STR0004#ALL#Identifica��o do Estabelecimento de Saude
0005#STR0005#ALL#Nome do Estabelecimento Solicitante
0006#STR0006#ALL#CNES
0007#STR0007#ALL#Nome do Estabelecimento Executante
0008#STR0008#ALL#Identifica��o do Paciente
0009#STR0009#ALL#Nome do Paciente
0010#STR0010#ALL#N� do Prontu�rio
0011#STR0011#ALL#Cartao Nacional de Sa�de (CNS)
0012#STR0012#ALL#Data de Nascimento
0013#STR0013#ALL#SEXO
0014#STR0014#ALL#Masc.
0015#STR0015#ALL#Fem.
0016#STR0016#ALL#Raca/Cor
0017#STR0017#ALL#Nome da M�e 
0018#STR0018#ALL#DDD
0019#STR0019#ALL#Telefone de Contato
0020#STR0020#ALL#Nome do Respons�vel
0021#STR0021#ALL#Endere�o (Rua, n�, bairro)
0022#STR0022#ALL#Munic�pio de Resid�ncia
0023#STR0023#ALL#Cod. IBGE Munic�pio
0024#STR0024#ALL#UF
0025#STR0025#ALL#CEP
0026#STR0026#ALL#JUSTIFICATIVA DA INTERNA��O
0027#STR0027#ALL#Principais Sinais e Sintomas Clinicos
0028#STR0028#ALL#Condic�es que Justificam a Interna��o
0029#STR0029#ALL#Principais Resultados de Provas Diagnosticas(Resultados de Exames Realizados)
0030#STR0030#ALL#Diagn�stico Inicial
0031#STR0031#ALL#CID 10 Principal
0032#STR0032#ALL#CID 10 Secundario
0033#STR0033#ALL#CID 10 Causas Associadas
0034#STR0034#ALL#PROCEDIMENTO SOLICITADO 
0035#STR0035#ALL#Descri��o do Procedimento Solicitado
0036#STR0036#ALL#C�digo do Procedimento
0037#STR0037#ALL#Clinica
0038#STR0038#ALL#Carater da Interna��o
0039#STR0039#ALL#Documento
0040#STR0040#ALL#N� Documento (CNS/CPF) do Profissional Solicitante/Assistente
0041#STR0041#ALL#Nome do Profissional Solicitante/Assistente
0042#STR0042#ALL#Data da Solicita�ao
0043#STR0043#ALL#Assinatura e Carimbo (N� do Registro do Conselho)
0044#STR0044#ALL#PREENCHER EM CASO DE CAUSAS EXTERNAS (ACIDENTES OU VIOL�NCIAS)
0045#STR0045#ALL#CNPJ da Seguradora 
0046#STR0046#ALL#N�� do Bilhete 
0047#STR0047#ALL#S�rie 
0048#STR0048#ALL#CNPJ Empresa 
0049#STR0049#ALL#CNAE da Empresa 
0050#STR0050#ALL#CBOR 
0051#STR0051#ALL#V�nculo com a Previd�ncia 
0052#STR0052#ALL#Autoriza��o 
0053#STR0053#ALL#Nome do Profissional Autorizador 
0054#STR0054#ALL#Cod. Org�o Emissor
0055#STR0055#ALL#N� da Autoriza��o de Internac�o Hospitalar
0056#STR0056#ALL#N� Documento (CNS/CPF) do Profissional Autorizador
0057#STR0057#ALL#Assinatura e Carimbo (N� do Registro do Conselho)
0058#STR0058#ALL#LAUDO PARA SOLICITA��O/AUTORIZA��O DE MUDANCA DE PROCEDIMENTO E DE PROCEDIMENTO(S)ESPECIAL(AIS)
0059#STR0059#ALL#LAUDO PARA SOLICITA��O/AUTORIZA��O DE MUDANCA DE 
0060#STR0060#ALL#PROCEDIMENTO E DE PROCEDIMENTO(S)ESPECIAL(AIS)
0061#STR0061#ALL#FOLHA
0062#STR0062#ALL#N�mero da Autoriza��o de Interna��o Hospitalar (AIH)
0063#STR0063#ALL#MUDAN�A DE PROCEDIMENTO
0064#STR0064#ALL#Descri��o do Procedimento Solicitado - Anterior
0065#STR0065#ALL#C�digo do Procedimento - Anterior
0066#STR0066#ALL#Descri��o do Procedimento Solicitado - Mudan�a
0067#STR0067#ALL#C�digo do Procedimento - Mudan�a
0068#STR0068#ALL#SOLICITA��O DE PROCEDIMENTO(S) ESPECIAL(AIS)
0069#STR0069#ALL#Descri��o do Procedimento Principal
0070#STR0070#ALL#C�digo do Procedimento Principal
0071#STR0071#ALL#Solicita��o de Diarias de UTI e/ou Diaria de Acompanhante
0072#STR0072#ALL#Diaria de Acompanhante 
0073#STR0073#ALL#Diaria de UTI Tipo I 
0074#STR0074#ALL#Diaria de UTI Tipo II 
0075#STR0075#ALL#Diaria de UTI Tipo III 
0076#STR0076#ALL#Descri��o do Procedimento Especial
0077#STR0077#ALL#C�digo do Procedimento Especial
0078#STR0078#ALL#Qtde
0079#STR0079#ALL#JUSTIFICATIVA DA SOLICITA��O
0080#STR0080#ALL#PROFISSIONAL SOLICITANTE
0081#STR0081#ALL#Nome do Profissional Solicitante
0082#STR0082#ALL#N� Documento (CNS/CPF) do Profissional Solicitante
0083#STR0083#ALL#Assinatura e Carimbo (N� do Registro do Conselho)
0084#STR0084#ALL#AUTORIZA��O
0085#STR0085#ALL#Nome do Profissional Autorizador
0086#STR0086#ALL#SOLICITA��O DE PROCEDIMENTO(S) ESPECIAL(AIS) - CONTINUA��O
0087#STR0087#ALL#JUSTIFICATIVA DA SOLICITA��O (Continua��o)
0088#STR0088#ALL#Assinatura e Carimbo (N� do Registro do Conselho) do Profissional Solicitante
0089#STR0089#ALL#Assinatura e Carimbo (N� do Registro do Conselho) do Profissional Autorizador
0090#STR0090#ALL#Data da Autoriza��o
0091#STR0091#ALL#Aten��o
0092#STR0092#ALL#Valida��o Laudo SUS
0093#STR0093#ALL#Paciente cancelado!
0094#STR0094#ALL#Paciente n�o possui conv�nio SUS!
 

HSPAHR93_PT-PT.TRES

 0004#STR0004#ALL#Identifica��o do Estabelecimento de Sa�de
0011#STR0011#ALL#Cart�o Nacional de Sa�de (CNS)
0016#STR0016#ALL#Ra�a/Cor
0018#STR0018#ALL#Indicativo
0019#STR0019#ALL#Telefone de Contacto
0021#STR0021#ALL#Morada (Rua, n�, freguesia)
0022#STR0022#ALL#Concelho de Resid�ncia
0023#STR0023#ALL#C�d. IBGE Concelho
0024#STR0024#ALL#Prov�ncia
0025#STR0025#ALL#CP
0027#STR0027#ALL#Principais Sinais e Sintomas Cl�nicos
0028#STR0028#ALL#Condi��es que justificam a interna��o
0029#STR0029#ALL#Principais Resultados de Provas Diagn�sticas(Resultados de Exames Realizados)
0032#STR0032#ALL#CID 10 Secund�rio
0037#STR0037#ALL#Cl�nica
0038#STR0038#ALL#Car�ter da Interna��o
0040#STR0040#ALL#N� Documento (CNS/Nr.Contr.) do Profissional Solicitante/Assistente
0042#STR0042#ALL#Data da Solicita��o
0043#STR0043#ALL#Assinatura e Carimbo (N� do Registo do Conselho)
0045#STR0045#ALL#Nr.Contrib. da Seguradora 
0048#STR0048#ALL#Nr.Contrib. Empresa 
0054#STR0054#ALL#C�d. Org�o Emissor
0056#STR0056#ALL#N� Documento (CNS/Nr.Contrib.) do Profissional Autorizador
0057#STR0057#ALL#Assinatura e Carimbo (N� do Registo do Conselho)
0058#STR0058#ALL#LAUDO PARA SOLICITA��O/AUTORIZA��O DE MUDAN�A DE PROCEDIMENTO E DE PROCEDIMENTO(S)ESPECIAL(AIS)
0059#STR0059#ALL#LAUDO PARA SOLICITA��O/AUTORIZA��O DE MUDAN�A DE 
0071#STR0071#ALL#Solicita��o de Diarias de UTI e/ou Di�ria de Acompanhante
0072#STR0072#ALL#Di�ria de Acompanhante 
0073#STR0073#ALL#Di�ria de UTI Tipo I 
0074#STR0074#ALL#Di�ria de UTI Tipo II 
0075#STR0075#ALL#Di�ria de UTI Tipo III 
0078#STR0078#ALL#Qtd.
0082#STR0082#ALL#N� Documento (CNS/Nr.Contrib.) do Profissional Solicitante
0083#STR0083#ALL#Assinatura e Carimbo (N� do Registo do Conselho)
0088#STR0088#ALL#Assinatura e Carimbo (N� do Registo do Conselho) do Profissional Solicitante
0089#STR0089#ALL#Assinatura e Carimbo (N� do Registo do Conselho) do Profissional Autorizador
0090#STR0090#ALL#Data da autoriza��o
 

HSPAHR93_RU.TRES

 0001#STR0001#ALL#REPORT TO REQUEST AUTHORIZATION FOR HOSPITALIZATION
0002#STR0002#ALL#REPORT TO REQUEST AUTHORIZATION 
0003#STR0003#ALL#FOR HOSPITALIZATION
0004#STR0004#ALL#Identification of Health Care Establishment
0005#STR0005#ALL#Name of Requester Establishment
0006#STR0006#ALL#CNES
0007#STR0007#ALL#Name of Executer Establishment
0008#STR0008#ALL#Patient Identification
0009#STR0009#ALL#Patient Name
0010#STR0010#ALL#Medical record Number
0011#STR0011#ALL#National Health Card (CNS)
0012#STR0012#ALL#Birthday
0013#STR0013#ALL#GENDER
0014#STR0014#ALL#���.
0015#STR0015#ALL#���.  
0016#STR0016#ALL#Ethnicity/Color
0017#STR0017#ALL#Mother�s Name 
0018#STR0018#ALL#Long-distance code
0019#STR0019#ALL#Contact Phone
0020#STR0020#ALL#Name of responsible person
0021#STR0021#ALL#Address (street, no., district)
0022#STR0022#ALL#Residence City
0023#STR0023#ALL#Code IBGE City
0024#STR0024#ALL#�����
0025#STR0025#ALL#CEP (Zip Code)
0026#STR0026#ALL#HOSPITALIZATION REASON
0027#STR0027#ALL#Main Clinical Symptoms and Signs
0028#STR0028#ALL#Conditions that justify the hospitalization
0029#STR0029#ALL#Main results of Diagnostic Evidence (Results of Examinations)
0030#STR0030#ALL#Initials Diagnosis
0031#STR0031#ALL#ICD 10 Main
0032#STR0032#ALL#ICD 10 Secondary
0033#STR0033#ALL#ICD 10 Causes Associated
0034#STR0034#ALL#PROCEDURE REQUESTED 
0035#STR0035#ALL#Description of Procedure Requested
0036#STR0036#ALL#Procedure Code
0037#STR0037#ALL#Clinic
0038#STR0038#ALL#Hospitalization Characteristic
0039#STR0039#ALL#��������
0040#STR0040#ALL#Document No. (CNS/CPF) of Assistant/Requester Professional
0041#STR0041#ALL#Name of Assistant/Requester Professional
0042#STR0042#ALL#Request Date
0043#STR0043#ALL#Signature and Stamp (No. of Council Registration)
0044#STR0044#ALL#FILL OUT IN CASE OF EXTERNAL CAUSES (ACCIDENT OR VIOLENCE)
0045#STR0045#ALL#CNPJ of Insurance Company 
0046#STR0046#ALL#Ticket Number 
0047#STR0047#ALL#����� 
0048#STR0048#ALL#Company CNPJ 
0049#STR0049#ALL#Company CNAE 
0050#STR0050#ALL#CBOR 
0051#STR0051#ALL#Bond with Social Security 
0052#STR0052#ALL#�����������  
0053#STR0053#ALL#Name of Authorizer Professional 
0054#STR0054#ALL#Issuer Agency Code
0055#STR0055#ALL#Number of Hospitalization Authorization
0056#STR0056#ALL#Document No. (CNS/CPF) of Authorizer Professional
0057#STR0057#ALL#Signature and Stamp (No. of Council Registration)
0058#STR0058#ALL#REPORT FOR REQUEST/AUTHORIZATION FOR PROCEDURE CHANGE AND SPECIAL PROCEDURE(S)
0059#STR0059#ALL#REQUEST/AUTHORIZATION FOR PROCEDURE CHANGE 
0060#STR0060#ALL#AND SPECIAL PROCEDURE(S)
0061#STR0061#ALL#SHEET
0062#STR0062#ALL#Number of Authorization of Hospitalization (AIH)
0063#STR0063#ALL#PROCEDURE CHANGE
0064#STR0064#ALL#Description of Procedure Requested - Previous
0065#STR0065#ALL#Procedure Code - Previous
0066#STR0066#ALL#Description of Procedure Requested - Change
0067#STR0067#ALL#Procedure Code - Change
0068#STR0068#ALL#REQUEST OF SPECIAL PROCEDURE(S)
0069#STR0069#ALL#Description of Main Procedure
0070#STR0070#ALL#Code of Main Procedure
0071#STR0071#ALL#Request of ICU Daily Rate and/or Companion Daily Rate
0072#STR0072#ALL#Companion Daily Rate 
0073#STR0073#ALL#Type I ICU Daily Rate 
0074#STR0074#ALL#Type II ICU Daily Rate 
0075#STR0075#ALL#Type III ICU Daily Rate 
0076#STR0076#ALL#Description of Special Procedure
0077#STR0077#ALL#Code of Special Procedure
0078#STR0078#ALL#����� 
0079#STR0079#ALL#REQUEST JUSTIFICATION
0080#STR0080#ALL#REQUESTER PROFESSIONAL
0081#STR0081#ALL#Name of Requester Professional
0082#STR0082#ALL#Document No. (CNS/CPF) of Requester Professional
0083#STR0083#ALL#Signature and Stamp (No. of Council Registration)
0084#STR0084#ALL#AUTHORIZATION
0085#STR0085#ALL#Name of Authorizer Professional
0086#STR0086#ALL#REQUEST OF SPECIAL PROCEDURES - CONTINUE
0087#STR0087#ALL#REQUEST JUSTIFICATION (Continuation)
0088#STR0088#ALL#Signature and Stamp (No. of Council Registration) of Requester Professional
0089#STR0089#ALL#Signature and Stamp (No. of Council Registration) of Authorizer Professional
0090#STR0090#ALL#���� �������.     
0091#STR0091#ALL#�������� 
0092#STR0092#ALL#SUS Report Validation
0093#STR0093#ALL#Patient cancelled!
0094#STR0094#ALL#Patient has no agreement with SUS!