國軍桃園總醫院英文診斷證明申請單
Application for an English version of diagnosis statement at the Taoyuan Armed Forces General Hospital
註：
一、 軍人免費，一般身份英文診斷證明（批價代碼：DOC003）每份壹佰元整。（The English version of
diagnosis statement is free for military personnel. The general public will be charged NT$100 for this
service.）
二、 本申請單連同醫師開具之英文診斷證明書交由申請人至掛號櫃台批價後，再至服務台用印，始完成
手續。（The applicant needs to bring the application and the diagnosis statement to the cashier. After
paying the required fees, the applicant needs to have the statement stamped with the official TSGH seal at the service counter.）
三、 本申請單由服務台收存，並將英文診斷證明書影印一份備查。（The service counter will retain the
application and a copy of the diagnosis statement for records.）
國軍桃園總醫院英文診斷證明申請單
Application for an English version of diagnosis statement at the Taoyuan Armed Forces General Hospital
註：
一、 軍人免費，一般身份英文診斷證明（批價代碼：DOC003）每份壹佰元整。（The English version of
diagnosis statement is free for military personnel. The general public will be charged NT$100 for this
service.）
二、 本申請單連同醫師開具之英文診斷證明書交由申請人至掛號櫃台批價後，再至服務台用印，始完成
手續。（The applicant needs to bring the application and the diagnosis statement to the cashier. After
paying the required fees, the applicant needs to have the statement stamped with the official TSGH seal at the service counter.）
三、 本申請單由服務台收存，並將英文診斷證明書影印一份備查。（The service counter will retain the
application and a copy of the diagnosis statement for records.）