466 lines
18 KiB
PHP
466 lines
18 KiB
PHP
<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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@php
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$dynamicVariableName = 'font_size_' . now()->timestamp;
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$$dynamicVariableName = 10;
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@endphp
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<style>
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.triangle1 {
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width: 0;
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height: 0;
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border-left: 10.24px solid transparent;
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border-right: 318.24px solid transparent;
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border-bottom: 75.5px solid #008C8C;
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position: absolute;
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top: -55.12px;
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left: -60.91px;
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transform: rotate(-12deg);
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}
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.triangle2 {
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width: 0;
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height: 0;
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border-left: 10.24px solid transparent;
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border-right: 550.24px solid transparent;
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border-bottom: 110.5px solid #19BBBB;
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position: absolute;
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top: -55.12px;
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left: -100.91px;
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transform: rotate(-20deg);
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}
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body {
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margin: 0;
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padding: 0;
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height: 100vh;
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background-color: #ffffff;
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/* Ganti dengan warna latar belakang yang diinginkan */
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}
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.content-<?php echo now()->timestamp; ?> {
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padding: 20px;
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text-align: left;
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font-family: 'Calibri', sans-serif;
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}
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.content-<?php echo now()->timestamp; ?> img {
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width: 15%;
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max-width: 600px; /* batasan lebar maksimum gambar */
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margin-top: 1px; /* jarak antara segitiga dan gambar */
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margin-bottom: 5px;
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}
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.corner-text-<?php echo now()->timestamp; ?> {
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font-size: {{ $$dynamicVariableName }}px;
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color: #666666;
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position: absolute;
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}
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.top-right-<?php echo now()->timestamp; ?> {
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top: 10px;
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right: 10px;
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}
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.bottom-right-<?php echo now()->timestamp; ?> {
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bottom: 10px;
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right: 10px;
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text-align: right;
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}
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.bottom-left-<?php echo now()->timestamp; ?> {
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bottom: 10px;
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left: 10px;
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text-align: left;
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}
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.title-container-<?php echo now()->timestamp; ?> {
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display: flex;
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flex-direction: column;
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align-items: center;
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text-align: center;
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position: relative;
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margin-top: 1px;
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}
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.title-<?php echo now()->timestamp; ?> {
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font-size: 12px;
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margin-bottom: 5px;
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}
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.additional-text-<?php echo now()->timestamp; ?> {
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font-size: 11px;
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}
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.claim-info-<?php echo now()->timestamp; ?> {
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font-size: {{ $$dynamicVariableName }}px;
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/* color: #008C8C; */
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text-align: justify;
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margin: 0;
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padding: 0;
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margin-top: 2px;
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line-height: 1; /* Atur nilai line-height menjadi 1 atau 100% */
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}
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table {
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width: 100%;
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border-collapse: collapse;
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margin-top: 1px;
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}
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table,
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th,
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td {
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/* border: 1px solid #008C8C; */
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}
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th,
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td {
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padding: 4px;
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text-align: left;
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}
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.hot-line-<?php echo now()->timestamp; ?> {
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background-color: #048B8C;
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text-align: center;
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align-items: center;
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font-size: {{ $$dynamicVariableName }}px;
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margin-top: 1px;
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padding: 2px;
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color: #ffffff;
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}
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.txt-tindakan-<?php echo now()->timestamp; ?> {
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margin-top: 1px;
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font-size: {{ $$dynamicVariableName }}px;
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}
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.txt-pernyataan-<?php echo now()->timestamp; ?> {
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margin-top: 5px;
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font-size: {{ $$dynamicVariableName }}px;
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}
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.title-container-page-<?php echo now()->timestamp; ?> {
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display: flex;
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flex-direction: column;
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text-align: justify;
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position: relative;
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/* border: 1px solid; Warna garis tepi dan lebar dapat disesuaikan */
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padding: 3px;
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margin-left: auto;
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margin-right: auto;
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margin-top: 5px;
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}
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.txt-syarat-<?php echo now()->timestamp; ?> {
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font-size: {{ $$dynamicVariableName }}px;
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text-align: left;
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}
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.bottom-left-ttd-<?php echo now()->timestamp; ?> {
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color: #000000;
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bottom: 100px;
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text-align: left;
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}
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.bottom-left-ttd-1-<?php echo now()->timestamp; ?> {
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color: #000000;
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bottom: 190px;
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text-align: left;
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}
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.bottom-left-ttd-2-<?php echo now()->timestamp; ?> {
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color: #000000;
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bottom: 110px;
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left: 15px;
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text-align: left;
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}
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.bottom-right-ttd-<?php echo now()->timestamp; ?> {
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color: #000000;
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bottom: 300px;
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right: 10px;
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text-align: left;
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}
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.bottom-right-ttd-1-<?php echo now()->timestamp; ?> {
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color: #000000;
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bottom: 290px;
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right: 10px;
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text-align: left;
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}
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.bottom-right-ttd-2-<?php echo now()->timestamp; ?> {
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color: #000000;
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bottom: 225px;
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right: 30px;
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text-align: left;
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}
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.bottom-right1-ttd-<?php echo now()->timestamp; ?> {
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color: #000000;
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bottom: 100px;
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right: 10px;
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text-align: left;
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}
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.logo_company-<?php echo now()->timestamp; ?> {
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position: absolute;
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top: -35.12px;
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left: -35.91px;
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width: 10%;
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max-width: 45px; /* batasan lebar maksimum gambar */
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margin-top: 1px; /* jarak antara segitiga dan gambar */
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margin-bottom: 5px;
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}
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.container2-<?php echo now()->timestamp; ?>:after {
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content: "";
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display: table;
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clear: both;
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}
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.container2-<?php echo now()->timestamp; ?> > div {
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float: left; /* Membuat elemen berdampingan */
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width: 48%; /* Atur lebar elemen agar mereka tidak tumpang tindih */
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box-sizing: border-box; /* Menghitung padding dan border ke dalam lebar elemen */
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}
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</style>
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</head>
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<body>
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<div class="triangle2"></div>
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<div class="triangle1"></div>
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@php
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$logoPath = !empty($logoPerusahaan->path) ? storage_path('app/public/' . $logoPerusahaan->path) : null;
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if (!empty($logoPath) && is_file($logoPath)) {
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$imgSrc = 'data:image/png;base64,' . base64_encode(file_get_contents($logoPath));
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echo '<img class="logo_company-' . now()->timestamp . '" src="' . $imgSrc . '">';
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}
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@endphp
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<div class="content-<?php echo now()->timestamp; ?>">
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<div class="corner-text-<?php echo now()->timestamp; ?> top-right-<?php echo now()->timestamp; ?>">
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The Future Of Healthcare At Your Fingertips
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</div>
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<img src="data:image/png;base64,{{ base64_encode(file_get_contents( public_path('images/logo-default.png') )) }}">
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<div class="title-container-<?php echo now()->timestamp; ?>">
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<div class="title-<?php echo now()->timestamp; ?>">
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<b>SURAT JAMINAN</b>
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</div>
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<div class="additional-text-<?php echo now()->timestamp; ?>">
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<b>(SURAT JAMINAN INI HARUS DITANDATANGANI OLEH PASIEN)</b>
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</div>
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</div>
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<table class="claim-info-<?php echo now()->timestamp; ?>">
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<tr>
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<td style="width: 20%;">No. Klaim</td>
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<td style="width: 1%;">:</td>
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<td style="width: 29%;">{{ wordwrap($request_logs->code, 15, "<br>\n") }}</td>
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<td style="width: 20%;">Tanggal</td>
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<td style="width: 1%;">:</td>
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<td style="width: 29%;">{{ \Carbon\Carbon::parse($request_logs->created_at)->format('d M Y') }}
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</td>
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</tr>
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<tr>
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<td>Kepada</td>
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<td>:</td>
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<td>{{ !empty($rumahSakit->nama_rumahsakit) ? $rumahSakit->nama_rumahsakit : '' }}</td>
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<td>Plan Polis</td>
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<td>:</td>
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<td>{{ $dataMember->code_plan }}</td>
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</tr>
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</table>
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<!-- <div class="hot-line-<?php echo now()->timestamp; ?>">
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<b>Call Center LinkSehat : 08114123962</b>
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</div> -->
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<div class="txt-tindakan-<?php echo now()->timestamp; ?>" style="margin-top: 5px;">
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LinkSehat bertindak mewakili perusahaan asuransi/penanggung untuk mengeluarkan Surat Jaminan Awal untuk peserta dibawah ini :
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</div>
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<div class="container2-<?php echo now()->timestamp; ?>">
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<div>
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<table class="claim-info-<?php echo now()->timestamp; ?>">
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<tr>
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<td style="width: 20%;">Jenis Surat Jaminan</td>
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<td style="width: 1%;">:</td>
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<td style="width: 29%;"><b>SURAT JAMINAN AWAL</b></td>
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</tr>
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<tr>
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<td>Nama Peserta</td>
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<td>:</td>
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<td>{{ $dataMember->name }}</td>
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</tr>
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<tr>
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<td>Nama Karyawan</td>
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<td>:</td>
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<td>{{ $namaKaryawan }}</td>
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</tr>
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<tr>
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<td>Tanggal Lahir</td>
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<td>:</td>
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<td>{{ \Carbon\Carbon::parse($dataMember->birth_date)->format('d M Y') }}</td>
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</tr>
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<tr>
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<td>Jenis Kelamin</td>
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<td>:</td>
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<td>{{ $dataMember->gender == 'male' ? 'Laki-Laki' : 'Perempuan' }}</td>
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</tr>
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<tr>
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<td>Member ID (BN)</td>
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<td>:</td>
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<td>{{ $dataMember->member_id }}</td>
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</tr>
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<tr>
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<td>Identitas Peserta</td>
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<td>:</td>
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<td>{{ $dataMember->nric }}</td>
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</tr>
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<tr>
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<td>Hak Kamar Pasien</td>
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<td>:</td>
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<td>{{ !empty($dataRequestLog->hak_kamar_pasien) ? $dataRequestLog->hak_kamar_pasien : ''}}</td>
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</tr>
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<tr>
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<td>Penempatan Kamar</td>
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<td>:</td>
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<td>{{ !empty($dataRequestLog->penempatan_kamar) ? $dataRequestLog->penempatan_kamar : ''}}</td>
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</tr>
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<tr>
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<td>No. Rekam Medis</td>
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<td>:</td>
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<td></td>
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</tr>
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<tr>
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<td>Jenis Perawatan</td>
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<td>:</td>
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<td>{{ $dataMember->jenis_perwatan }}</td>
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</tr>
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</table>
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</div>
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<div>
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<table class="claim-info-<?php echo now()->timestamp; ?>">
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<tr>
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<td style="width: 20%;">Penjamin</td>
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<td style="width: 1%;">:</td>
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<td style="width: 29%;">{{ $penjamin }}</td>
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</tr>
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<tr>
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<td>Nama Perusahaan</td>
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<td>:</td>
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<td>{{ $dataMember->branch_code }}</td>
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</tr>
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<tr>
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<td>Phone Perusahaan</td>
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<td>:</td>
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<td>0896-8177-3366</td>
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</tr>
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<tr>
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<td>No. Polis</td>
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<td>:</td>
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<td>{{ $dataMember->no_polis }}</td>
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</tr>
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<tr>
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<td>Tipe</td>
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<td>:</td>
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<td>Tarif IM-009 {{ $dataMember->limit_rules == '999999999' ? 'As Charge' : 'Max Amount, Rp '.number_format($dataMember->limit_rules, 2, ',', '.') }}</td>
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</tr>
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<tr>
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<td>Status Polis</td>
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<td>:</td>
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<td>{{ $dataMember->status_polis == 'active' ? 'Aktif' : 'Tidak Aktif' }}</td>
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</tr>
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<tr>
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<td>Periode Jaminan</td>
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<td>:</td>
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<td>{{ \Carbon\Carbon::parse($request_logs->submission_date)->format('d M Y') }}</td>
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</tr>
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<tr>
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<td>Mata Uang</td>
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<td>:</td>
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<td>{{ $dataMember->mata_uang }}</td>
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</tr>
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<tr>
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<td>Alamat Provider</td>
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<td>:</td>
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<td>{{ !empty($rumahSakit->alamat_rumahsakit) ? $rumahSakit->alamat_rumahsakit : '' }}</td>
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</tr>
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<tr>
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<td></td>
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<td></td>
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<td></td>
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</tr>
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<tr>
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<td></td>
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<td></td>
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<td></td>
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</tr>
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</table>
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</div>
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</div>
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<div class="txt-pernyataan-<?php echo now()->timestamp; ?>">
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<b>Keterangan:</b> {{ !empty($dataRequestLog->keterangan) ? $dataRequestLog->keterangan : ''}}
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</div>
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<div class="txt-pernyataan-<?php echo now()->timestamp; ?>">
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Mohon konfirmasi ke Primayan Medicare jika ada rujukan pasien ke spesialis lain.<br/>
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Surat Jaminan ini dinyatakan berlaku apabila disertai surat jaminan akhir dengan nominal yang tertera pada akhir perawatan.
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</div>
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<div class="title-container-page-<?php echo now()->timestamp; ?>">
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<div class="txt-syarat-<?php echo now()->timestamp; ?>">SYARAT DAN KETENTUAN</div>
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<table class="claim-info-<?php echo now()->timestamp; ?>">
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<tr>
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<td style="width: 3%;">1.</td>
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<td style="width: 97%;">Layanan yang tidak sesuai ketentuan, prosedur dan indikasi medis.</td>
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</tr>
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<tr>
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<td>2.</td>
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<td>Penyakit dan/atau kecelakaan yang diakibatkan oleh perbuatan sendiri (upaya bunuh diri, penyalahgunaan narkoba/zat adiktif lain, bermain petasan).</td>
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</tr>
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<tr>
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<td>3.</td>
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<td>Alat bantu kesehatan antara lain namun tidak terbatas pada: kursi roda, tongkat penyangga, korset, kantong es, botol air hangat, pispot, kasur decubitus, decker, underpad.</td>
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</tr>
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<tr>
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<td>4.</td>
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<td>Biaya administrasi lain yang tidak terkait dengan pengobatan (misalnya administrasi pengurusan surat keterangan kelahiran/kematian, resume medis, visum et repertum), biaya transportasi, fotokopi, telepon, serta pemulihan kesehatan selain di rumah sakit (homecare, sanatorium dan sejenisnya).</td>
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</tr>
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<tr>
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<td>5.</td>
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<td>Pemulihan kesehatan selain di rumah sakit (homecare, sanatorium dan sejenisnya).</td>
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</tr>
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<tr>
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<td>6.</td>
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<td>Pengobatan akibat tindakan melanggar hukum, kriminal, melawan penahanan yang sah, serta akibat provokasi yang dilakukan peserta.</td>
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</tr>
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<tr>
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<td>7.</td>
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<td>Ikut berpartisipasi dalam peperangan (baik yang dinyatakan maupun tidak), keadaan seperti perang, pemberontakan, perebutan kekuasaan, huru-hara, keributan, tindakan kriminal, aktivitas melanggar hukum atau berdinas di angkatan bersenjata atau kepolisian.</td>
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</tr>
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<tr>
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<td>8.</td>
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<td>Bencana alam seperti gempa bumi, tsunami, gunung meletus, banjir, kekeringan, angin topan, dan tanah longsor, termasuk kondisi lain yang ditetapkan pemerintah sebagai keadaan darurat.</td>
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</tr>
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<tr>
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<td>9.</td>
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<td>Home nursing (perawatan di rumah) atau perawatan pribadi.</td>
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</tr>
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</table>
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</div>
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<div class="corner-text-<?php echo now()->timestamp; ?> bottom-left-ttd-1-<?php echo now()->timestamp; ?> ">
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Hormat Kami,<br>
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{{ $namaPenjaminTtd }}
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</div>
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<div class="corner-text-<?php echo now()->timestamp; ?> bottom-left-ttd-2-<?php echo now()->timestamp; ?> ">
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@php
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if(!empty($ttdImage) && file_exists($ttdImage)) {
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$imgSrc = 'data:image/png;base64,' . base64_encode(file_get_contents($ttdImage));
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echo '<img style="width: 120px; height: 80px;" src="' . $imgSrc . '">';
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}
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@endphp
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</div>
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<div class="corner-text-<?php echo now()->timestamp; ?> bottom-left-ttd-<?php echo now()->timestamp; ?> ">
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<u><b>{{ $ttdNama }}</b></u>
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<br><b>{{ $ttdJabatan }}</b>
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</div>
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<div class="corner-text-<?php echo now()->timestamp; ?> bottom-right-<?php echo now()->timestamp; ?>">
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<b>PT Link Medis Sehat</b><br>
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<b>Primaya Hospital Corporate</b><br>
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Graha Cempaka Mas Blok D5-6<br>
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Jl. Let. Jend. Suprapto, Jakarta Pusat 10640, Indonesia<br>
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<b>Telp</b> 0896-8177-3366
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</div>
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</div>
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</body>
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</html>
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