|
DATOS DEL PACIENTE:
Tipo de Documento: {{ $invoice->authorization->patient->dni_type}} Número de Documento: {{ $invoice->authorization->patient->dni}} {{ $invoice->authorization->patient->full_name}} |
DATOS DE LA EMPRESA:
{{ $invoice->eps->code }} - {{ $invoice->eps->name }} NIT: {{ $invoice->eps->nit }} Dirección: {{ $invoice->eps->address->address }} Tel: {{ $invoice->eps->phone->phone }} |
| No. Factura | Datos del afiliado | Cant. | Valor Facturas | ||
| {{ $invoice->format_number }} | {!! $currentAuthorization->patient->dni !!} | {!! mb_strtoupper($currentAuthorization->patient->full_name) !!} | |||
| › {!! $authorizationService->service->code !!} | {{ mb_strtoupper($authorizationService->service->name) }} | {{ mb_strtoupper($currentAuthorization->codec) }} | {!! $authorizationService->days !!} | $ {!! number_format($currentTotal, 0, ",", ".") !!} | |
| › {!! $service->code !!} | {{ mb_strtoupper($service->name) }} | {{ mb_strtoupper($currentAuthorization->codec) }} | {!! json_decode($invoice->multiple_days, true)[$k] !!} | $ {!! number_format($currentTotal, 0, ",", ".") !!} | |
| {{ $invoice->format_number }} | {!! $invoice->authorization->patient->dni !!} | {{ mb_strtoupper($invoice->authorization->patient->last_name.' '.$invoice->authorization->patient->first_name) }} | |||
| › {!! $authorizationService->service->code !!} | {{ mb_strtoupper($authorizationService->service->name) }} | {{ mb_strtoupper($invoice->authorization->codec) }} | {!! $authorizationService->days !!} | $ {!! number_format($currentTotal, 0, ",", ".") !!} | |
| › {{ $service->code }} | {{ mb_strtoupper($service->name) }} | {!! $invoice->authorization->codec !!} | {!! $invoice->days !!} | $ {!! number_format($currentTotal, 0, ",", ".") !!} | |
| Subtotal Factura | $ {!! number_format($subTotal, 0, ",", ".") !!} | ||||
| TOTAL: | $ {!! number_format($total, 0, ",", ".") !!} | ||||
|
Firma de la persona autorizada |
Recibido: ___________________________
C.C.: _______________________________ Fecha: ________/__________/__________ DIA MES AÑO |