CAREWORKS HMIS

	Division	:
	Location	:

DOCTOR TYPE

HOSPITAL DOCTOR

OUTSIDE REFERRAL DOCTOR

*

DOCTOR

*

MONTHLY FIXED AMOUNT

*

START DATE

*

END DATE

* SCHEME

ALL CHARGES

* CHARGE

ALL SERVICES

* SERVICE

RATE

BY PERCENTAGE

BY AMOUNT

SOURCE IS NOT ATTACHED TO SELECTED CHARGE AND SERVICES.