Traditional-Chinese outpatient (門診) fee receipt (費用收據) from Chang Gung Memorial Hospital (長庚紀念醫院). Two labeled sections: 自付費用項目及金額 (self-pay charge items and amounts) and 健保申報項目及點數 (national-health-insurance reported items and points). These are fixed named fields, not a variable table, so each maps to its own property. Dates are in ROC era format (e.g. 104/11/30); record exactly as printed. Amounts and points are integers. 收據金額 is the receipt amount actually collected. Patient name and ID values stay in original script as printed; field names and descriptions in English.
