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Get FORMULIR KLAIM RAWAT INAP DAN RAWAT BEDAH HOSPITAL

Ng pasien dan harus diisi dengan lengkap dan ditandatangani oleh peserta atau orang tua jika pasien adalah anak-anak. This form should be completed for the inpatient claims of ONE patient only and must be fully completed and signed by the insured person or by his/her parents for minor patient. 2. Formulir ini harus diisi dengan lengkap, benar dan jelas. This form should be filled in correctly, completely and clearly. 3. Klaim baru dapat diteliti dan diproses lebih lanjut hanya bila semua dokumen.

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