Modèle de protocole d 'indemnisation en cas d' accident médical

A: u \ \ u \ \ u \ \ u \ \ u \ \ u \ \ U

B: \ \ U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U

A) les parties conviennent, à l 'issue de consultations et de leur plein gré, conformément aux dispositions de l' ordonnance sur le traitement des accidents médicaux, de ce qui suit:

Situation de base du patient

Nom: nom: uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu UU UU U U U

Carte d 'identité no \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ \\ \\\\\\\\\\\\\\\\\\\\\\\\\\

Le diagnostic de la maladie: uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu UU UU U U U U

Le résultat du traitement: uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu UU UU U U U

Niveau d 'accident médical défini conjointement par les Parties a et B

La cause de l 'accident médical \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ \\\\\\\\\\\\\\\\\\\\\\\\\\\\

INDEMNITéS

Frais médicaux: \ \ u \ \ u \ \ yuan;

2, les faux frais: \ \ u \ \ u \ \ yuan;

Allocation de repas d 'hospitalisation: \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \

Quatre,EscorterFei: \ \ u \ \ u \ \ u yuan;

Indemnité de subsistance pour invalidité: \ \ u \ \ u \ \ u \ \ yuan;

6, les co?ts des équipements d 'invalidité: \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \

Sept,FunéraillesFei: \ \ u \ \ u \ \ u yuan;

Pension alimentaire des personnes à charge: U U U U U U U U U U U yuan;

Neuf,TransportsFei: \ \ u \ \ u \ \ u yuan;

Frais d 'hébergement: \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \

Pension pour préjudice moral: \ \ \ u \ \ u \ \ yuan;

Frais de transport, d 'erreur de travail, d' hébergement du conjoint et des membres de la famille immédiate d 'un patient décédé participant à des funérailles: \ \ \ u \ \ u \ \ u \ \ Yuan (pas plus de deux personnes)

Total: \ \ u \ \ u \ \ u \ \ Yuan

V. Calendrier de paiement des indemnités

RESPONSABILITé en cas de violation

Autres

Sortie de l 'h?pital

S' il s' agit d 'un patient décédé, le corps est traité

Autres: \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\\\\\\\

Cet accord entrera en vigueur après avoir été signé ou scellé par les deux parties.