Include P12 V2 - PLSR431

PLSR431.CH

 #DEFINE STR0001 FWI18NLang("PLSR431","STR0001",1)
#DEFINE STR0002 FWI18NLang("PLSR431","STR0002",2)
#DEFINE STR0003 FWI18NLang("PLSR431","STR0003",3)
#DEFINE STR0004 FWI18NLang("PLSR431","STR0004",4)
#DEFINE STR0005 FWI18NLang("PLSR431","STR0005",5)
#DEFINE STR0006 FWI18NLang("PLSR431","STR0006",6)
#DEFINE STR0007 FWI18NLang("PLSR431","STR0007",7)
#DEFINE STR0008 FWI18NLang("PLSR431","STR0008",8)
#DEFINE STR0009 FWI18NLang("PLSR431","STR0009",9)
#DEFINE STR0010 FWI18NLang("PLSR431","STR0010",10)
#DEFINE STR0011 FWI18NLang("PLSR431","STR0011",11)
#DEFINE STR0012 FWI18NLang("PLSR431","STR0012",12)
#DEFINE STR0013 FWI18NLang("PLSR431","STR0013",13)
#DEFINE STR0014 FWI18NLang("PLSR431","STR0014",14)
#DEFINE STR0015 FWI18NLang("PLSR431","STR0015",15)
#DEFINE STR0016 FWI18NLang("PLSR431","STR0016",16)
#DEFINE STR0017 FWI18NLang("PLSR431","STR0017",17)
#DEFINE STR0018 FWI18NLang("PLSR431","STR0018",18)
#DEFINE STR0019 FWI18NLang("PLSR431","STR0019",19)
#DEFINE STR0020 FWI18NLang("PLSR431","STR0020",20)
#DEFINE STR0021 FWI18NLang("PLSR431","STR0021",21)
#DEFINE STR0022 FWI18NLang("PLSR431","STR0022",22)
#DEFINE STR0023 FWI18NLang("PLSR431","STR0023",23)
#DEFINE STR0024 FWI18NLang("PLSR431","STR0024",24)
#DEFINE STR0025 FWI18NLang("PLSR431","STR0025",25)
#DEFINE STR0026 FWI18NLang("PLSR431","STR0026",26)
#DEFINE STR0027 FWI18NLang("PLSR431","STR0027",27)
#DEFINE STR0028 FWI18NLang("PLSR431","STR0028",28)
#DEFINE STR0029 FWI18NLang("PLSR431","STR0029",29)
#DEFINE STR0030 FWI18NLang("PLSR431","STR0030",30)
#DEFINE STR0069 FWI18NLang("PLSR431","STR0069",31)
#DEFINE STR0073 FWI18NLang("PLSR431","STR0073",32)
#DEFINE STR0074 FWI18NLang("PLSR431","STR0074",33)
#DEFINE STR0075 FWI18NLang("PLSR431","STR0075",34)
#DEFINE STR0076 FWI18NLang("PLSR431","STR0076",35)
#DEFINE STR0077 FWI18NLang("PLSR431","STR0077",36)
#DEFINE STR0078 FWI18NLang("PLSR431","STR0078",37)
#DEFINE STR0079 FWI18NLang("PLSR431","STR0079",38)
#DEFINE STR0080 FWI18NLang("PLSR431","STR0080",39)
#DEFINE STR0081 FWI18NLang("PLSR431","STR0081",40)
#DEFINE STR0082 FWI18NLang("PLSR431","STR0082",41)
#DEFINE STR0083 FWI18NLang("PLSR431","STR0083",42)
#DEFINE STR0084 FWI18NLang("PLSR431","STR0084",43)
#DEFINE STR0085 FWI18NLang("PLSR431","STR0085",44)
#DEFINE STR0086 FWI18NLang("PLSR431","STR0086",45)
#DEFINE STR0087 FWI18NLang("PLSR431","STR0087",46)
#DEFINE STR0088 FWI18NLang("PLSR431","STR0088",47)
#DEFINE STR0089 FWI18NLang("PLSR431","STR0089",48)
#DEFINE STR0090 FWI18NLang("PLSR431","STR0090",49)
#DEFINE STR0091 FWI18NLang("PLSR431","STR0091",50)
#DEFINE STR0092 FWI18NLang("PLSR431","STR0092",51)
#DEFINE STR0093 FWI18NLang("PLSR431","STR0093",52)
 

PLSR431_EN.TRES

 0001#STR0001#ALL#FORM AUTHORIZATION  
0002#STR0002#ALL#Printing of Form Authorization   
0003#STR0003#ALL#according to user's configuration.      
0004#STR0004#ALL#Z.form 
0005#STR0005#ALL#Management   
0006#STR0006#ALL# No : 
0007#STR0007#ALL#Form valid for                  from        
0008#STR0008#ALL#ANS :
0009#STR0009#ALL#Date 
0010#STR0010#ALL#Issued by: 
0011#STR0011#ALL#User       : 
0012#STR0012#ALL#Code    : 
0013#STR0013#ALL#Identity   : 
0014#STR0014#ALL#Sex  :
0015#STR0015#ALL#Date of Birth:     
0016#STR0016#ALL#Company    : 
0017#STR0017#ALL#Plan       : 
0018#STR0018#ALL#Requesting Docto   : 
0019#STR0019#ALL#CRM     : 
0020#STR0020#ALL#Authorized procedures    
0021#STR0021#ALL#Main CID      :
0022#STR0022#ALL#Performer  :
0023#STR0023#ALL#Secondary CID  : 
0024#STR0024#ALL#Beneficiary's Signature     
0025#STR0025#ALL#AMB/CBHPM
0026#STR0026#ALL#Descript.
0027#STR0027#ALL#Qty.
0028#STR0028#ALL#Days
0029#STR0029#ALL#
0030#STR0030#ALL#Attention: This form is valid only for the service detailed     
0031#STR0069#ALL#Psswrd: 
0032#STR0073#ALL#Notes:       
0033#STR0074#ALL#Responsible Doctor's stamp and signature  
0034#STR0075#ALL#UNIMED's Stamp   
0035#STR0076#ALL#Co-particip. Amnt. 
0036#STR0077#ALL#No printed connected to this computer. Unable to print.                                     
0037#STR0078#ALL#
0038#STR0079#ALL#REJECTED AUTHORIZATION - PRINTING REQUESTED BY THE USER
0039#STR0080#ALL#Tooth
0040#STR0081#ALL#Face
0041#STR0082#ALL#Service Code     
0042#STR0083#ALL#Confirm eligibility of insured in attendance by requiring Identification Card and proof of validity.                                 
0043#STR0084#ALL#SERVICES
0044#STR0085#ALL#Payment of Tax on Services of any Class, levying this provision of services is full responsibility of the authorized party and cannot be                         
0045#STR0086#ALL#the insurer to be fined for any omission.          
0046#STR0087#ALL#or Area
0047#STR0088#ALL#ODONTOLOGICAL TREATMENT
0048#STR0089#ALL#Authorized (signature under stamp)   
0049#STR0090#ALL#Patient or Responsible 
0050#STR0091#ALL#Odontological Consultant
0051#STR0092#ALL#TOTAL      
0052#STR0093#ALL#Co-Particip. Amount
 

PLSR431_ES.TRES

 0001#STR0001#ALL#AUTORIZACION DE GUIA 
0002#STR0002#ALL#Impresion de Autorizacion de Guia 
0003#STR0003#ALL#segun la configuracion del usuario.
0004#STR0004#ALL#A Rayas
0005#STR0005#ALL#Administracion
0006#STR0006#ALL# No : 
0007#STR0007#ALL#Guia V�leida por                        a partir de 
0008#STR0008#ALL#ANS :
0009#STR0009#ALL#Fecha 
0010#STR0010#ALL#Emitente : 
0011#STR0011#ALL#Usuario    : 
0012#STR0012#ALL#Codigo  : 
0013#STR0013#ALL#Identidad : 
0014#STR0014#ALL#Sexo :
0015#STR0015#ALL#Fecha de Nacimiento:
0016#STR0016#ALL#Empresa    : 
0017#STR0017#ALL#Plan      : 
0018#STR0018#ALL#Medico Solicitante : 
0019#STR0019#ALL#CRM     : 
0020#STR0020#ALL#Procedimientos autorizados
0021#STR0021#ALL#CID Principal :
0022#STR0022#ALL#Ejecutante :
0023#STR0023#ALL#CID Secundario : 
0024#STR0024#ALL#Firma de Beneficiario 
0025#STR0025#ALL#AMB/CBHPM
0026#STR0026#ALL#Descripcion
0027#STR0027#ALL#Ctd
0028#STR0028#ALL#Dias
0029#STR0029#ALL#
0030#STR0030#ALL#Atencion : Esta guia� v�leida unicamente para el servicio especificado
0031#STR0069#ALL#Clave : 
0032#STR0073#ALL#Observaciones: 
0033#STR0074#ALL#Sello y Firma del Medico Responsable
0034#STR0075#ALL#Sello de Unimed
0035#STR0076#ALL#Vlr Coparticipacion
0036#STR0077#ALL#No existe ninguna impresora conectada a esta maquina. No se podra hacer la impresion.
0037#STR0078#ALL#
0038#STR0079#ALL#AUTORIZACION NEGADA - IMPRESION SOLICITADA POR EL USUARIO.
0039#STR0080#ALL#Dente ou Area
0040#STR0081#ALL#Face
0041#STR0082#ALL#Codigo do Servi�o
0042#STR0083#ALL#Confirme a elegibilidade do segurado no atendimento, exigindo a apresenta��o do Cart�o de Identifica��o e do comprovante de validade.
0043#STR0084#ALL#SERVICOS
0044#STR0085#ALL#O recolhimento do Imposto Sobre Servi�os de Qualquer Natureza, incidente sobre esta presta��o de servi�o � de total responsabilidade do referenciado, n�o podendo
0045#STR0086#ALL#a seguradora ser penalizada por quaisquer omiss�es.
0046#STR0087#ALL#ou Area
0047#STR0088#ALL#TRATAMENTO ODONTOLOGICO
0048#STR0089#ALL#Referenciado (firma con timbre)
0049#STR0090#ALL#Paciente ou Respons�vel
0050#STR0091#ALL#Consultor Odontologico
0051#STR0092#ALL#TOTALIZACAO
0052#STR0093#ALL#Vlr Co-Participa��o
 

PLSR431_PT-BR.TRES

 0001#STR0001#ALL#AUTORIZA��O DE GUIA 
0002#STR0002#ALL#Impressao da Autoriza��o de Guia 
0003#STR0003#ALL#de acordo com a configura��o do usu�rio.
0004#STR0004#ALL#Zebrado
0005#STR0005#ALL#Administra��o
0006#STR0006#ALL# No : 
0007#STR0007#ALL#Guia V�lida por                 a partir de 
0008#STR0008#ALL#ANS :
0009#STR0009#ALL#Data 
0010#STR0010#ALL#Emitente : 
0011#STR0011#ALL#Usu�rio    : 
0012#STR0012#ALL#Codigo  : 
0013#STR0013#ALL#Identidade : 
0014#STR0014#ALL#Sexo :
0015#STR0015#ALL#Data de Nascimento:
0016#STR0016#ALL#Empresa    : 
0017#STR0017#ALL#Plano      : 
0018#STR0018#ALL#M�dico Solicitante : 
0019#STR0019#ALL#CRM     : 
0020#STR0020#ALL#Procedimentos autorizados
0021#STR0021#ALL#CID Principal :
0022#STR0022#ALL#Executante :
0023#STR0023#ALL#CID Secund�rio : 
0024#STR0024#ALL#Assinatura  do Benefici�rio 
0025#STR0025#ALL#AMB/CBHPM
0026#STR0026#ALL#Descri��o
0027#STR0027#ALL#Qtde
0028#STR0028#ALL#Dias
0029#STR0029#ALL#
0030#STR0030#ALL#Aten��o : Esta guia � v�lida somente para o servi�o discriminado
0031#STR0069#ALL#Senha : 
0032#STR0073#ALL#Observa��es: 
0033#STR0074#ALL#Carimbo e Assinatura do M�dico Respons�vel
0034#STR0075#ALL#Carimbo da Unimed
0035#STR0076#ALL#Vlr Co-Participa��o
0036#STR0077#ALL#N�o Existe nenhuma impressora conectada a esta m�quina.N�o ser� possivel efetuar a impress�o
0037#STR0078#ALL#
0038#STR0079#ALL#AUTORIZACAO NEGADA - IMPRESSAO SOLICITADA PELO USUARIO.
0039#STR0080#ALL#Dente
0040#STR0081#ALL#Face
0041#STR0082#ALL#Codigo do Servi�o
0042#STR0083#ALL#Confirme a elegibilidade do segurado no atendimento, exigindo a apresenta��o do Cart�o de Identifica��o e do comprovante de validade.
0043#STR0084#ALL#SERVICOS
0044#STR0085#ALL#O recolhimento do Imposto Sobre Servi�os de Qualquer Natureza, incidente sobre esta presta��o de servi�o � de total responsabilidade do referenciado, n�o podendo
0045#STR0086#ALL#a seguradora ser penalizada por quaisquer omiss�es.
0046#STR0087#ALL#ou Area
0047#STR0088#ALL#TRATAMENTO ODONTOLOGICO
0048#STR0089#ALL#Referenciado (assinatura sob carimbo)
0049#STR0090#ALL#Paciente ou Respons�vel
0050#STR0091#ALL#Consultor Odontologico
0051#STR0092#ALL#TOTALIZACAO
0052#STR0093#ALL#Vlr Co-Participa��o
 

PLSR431_PT-PT.TRES

 0001#STR0001#ALL#AUTORIZA��O DE GUIA
0002#STR0002#ALL#Impress�o da autoriza��o de guia 
0003#STR0003#ALL#De acordo com a configura��o do utilizador.
0004#STR0004#ALL#C�digo de barras
0005#STR0005#ALL#Administra��o
0006#STR0006#ALL# no : 
0007#STR0007#ALL#Guia v�lida por                 a partir de 
0008#STR0008#ALL#Anos :
0011#STR0011#ALL#Utilizador    : 
0012#STR0012#ALL#C�digo  : 
0015#STR0015#ALL#Data De Nascimento:
0018#STR0018#ALL#M�dico solicitante : 
0019#STR0019#ALL#Nr.de registo na Ordem dos M�dicos    : 
0021#STR0021#ALL#Conc. principal :
0023#STR0023#ALL#CID secund�rio : 
0024#STR0024#ALL#Assinatura  do benefici�rio 
0025#STR0025#ALL#Amb/cbhpm
0026#STR0026#ALL#Descri��o
0031#STR0069#ALL#Palavra-passe : 
0032#STR0073#ALL#Observa��es: 
0033#STR0074#ALL#Carimbo E Assinatura Do M�dico Respons�vel
0034#STR0075#ALL#Carimbo Da Unimed
0036#STR0077#ALL#N�o Existe nenhuma impressora conectada a esta m�quina. N�o ser� poss�vel efetuar a impress�o
0038#STR0079#ALL#Autoriza��o Negada - Impress�o Pedida Pelo Utilizador.
0041#STR0082#ALL#C�digo do servi�o
0042#STR0083#ALL#Confirme a elegibilidade do segurado no atendimento, exigindo a apresenta��o do Cart�o de Identifica��o e do comprovante de validade.
0043#STR0084#ALL#Servi�os
0044#STR0085#ALL#O recolhimento do Imposto Sobre Servi�os de Qualquer Natureza, incidente sobre esta presta��o de servi�o � de total responsabilidade do referenciado, n�o podendo
0045#STR0086#ALL#A seguradora ser penalizada por quaisquer omiss�es.
0046#STR0087#ALL#Ou �rea
0047#STR0088#ALL#Tratamento Odontol�gico
0049#STR0090#ALL#Doente Ou Respons�vel
0050#STR0091#ALL#Consultor Odontol�gico
0051#STR0092#ALL#Totaliza��o
 

PLSR431_RU.TRES

 0001#STR0001#ALL#FORM AUTHORIZATION  
0002#STR0002#ALL#Printing of Form Authorization   
0003#STR0003#ALL#according to user's configuration.      
0004#STR0004#ALL#���� Z
0005#STR0005#ALL#����������
0006#STR0006#ALL# No : 
0007#STR0007#ALL#Form valid for                  from        
0008#STR0008#ALL#ANS :
0009#STR0009#ALL#����
0010#STR0010#ALL#Issued by: 
0011#STR0011#ALL#User       : 
0012#STR0012#ALL#Code    : 
0013#STR0013#ALL#Identity   : 
0014#STR0014#ALL#Sex  :
0015#STR0015#ALL#Date of Birth:     
0016#STR0016#ALL#Company    : 
0017#STR0017#ALL#Plan       : 
0018#STR0018#ALL#Requesting Docto   : 
0019#STR0019#ALL#CRM     : 
0020#STR0020#ALL#Authorized procedures    
0021#STR0021#ALL#Main CID      :
0022#STR0022#ALL#Performer  :
0023#STR0023#ALL#Secondary CID  : 
0024#STR0024#ALL#Beneficiary's Signature     
0025#STR0025#ALL#AMB/CBHPM
0026#STR0026#ALL#����.    
0027#STR0027#ALL#�-��
0028#STR0028#ALL#��� 
0029#STR0029#ALL#
0030#STR0030#ALL#Attention: This form is valid only for the service detailed     
0031#STR0069#ALL#Psswrd: 
0032#STR0073#ALL#����������:
0033#STR0074#ALL#Responsible Doctor's stamp and signature  
0034#STR0075#ALL#UNIMED's Stamp   
0035#STR0076#ALL#Co-particip. Amnt. 
0036#STR0077#ALL#No printed connected to this computer. Unable to print.                                     
0037#STR0078#ALL#
0038#STR0079#ALL#REJECTED AUTHORIZATION - PRINTING REQUESTED BY THE USER
0039#STR0080#ALL#Tooth
0040#STR0081#ALL#Face
0041#STR0082#ALL#Service Code     
0042#STR0083#ALL#Confirm eligibility of insured in attendance by requiring Identification Card and proof of validity.                                 
0043#STR0084#ALL#SERVICES
0044#STR0085#ALL#Payment of Tax on Services of any Class, levying this provision of services is full responsibility of the authorized party and cannot be                         
0045#STR0086#ALL#the insurer to be fined for any omission.          
0046#STR0087#ALL#or Area
0047#STR0088#ALL#ODONTOLOGICAL TREATMENT
0048#STR0089#ALL#Authorized (signature under stamp)   
0049#STR0090#ALL#Patient or Responsible 
0050#STR0091#ALL#Odontological Consultant
0051#STR0092#ALL#���� 
0052#STR0093#ALL#Co-Particip. Amount