СВОД ЗАТРАТ, ВКЛЮЧЕННЫХ В ПЛАНОВУЮ СЕБЕСТОИМОСТЬ НА ОКАЗАНИЕ АМБУЛАТОРНО-
ПОЛИКЛИНИЧЕСКОЙ МЕДИЦИНСКОЙ ПОМОЩИ, ПО КАЖДОМУ СТРУКТУРНОМУ ПОДРАЗДЕЛЕНИЮ
(РАЗВЕРНУТЫЙ)
Утвержден
постановлением Минздрава
от 14.03.2005 N 6
СВОД
ЗАТРАТ, ВКЛЮЧЕННЫХ В ПЛАНОВУЮ СЕБЕСТОИМОСТЬ НА ОКАЗАНИЕ
АМБУЛАТОРНО-ПОЛИКЛИНИЧЕСКОЙ МЕДИЦИНСКОЙ ПОМОЩИ,
ПО КАЖДОМУ СТРУКТУРНОМУ ПОДРАЗДЕЛЕНИЮ (РАЗВЕРНУТЫЙ)
по _____________________________________ на 200__ год
(наименование больничной организации)
--------------------------------------------------------------------------------
|N |Наименование|Статья|Под- |Элемент|Амбулаторно-поликлиническая медицинская|
|п/п| | |статья| |помощь |
-----------------------------------------
*-------------------------------------------------------------------------------
||||||Админис- |Основные |Кабинеты|Вспомогательные |Хозяй- |Всего затрат|
||||||тративно-|отделения | |структурные |ственно-| |
||||||управлен-| | |подразделения |обслужи-| |
||||||ческий | | | |вающий | |
||||||персонал | | | |персонал| |
*----- ------------------------------------------- --------------
---------------------------------------------------------------------------------------------------- ---------------
| | | | | | |женская |педиатри-|и т.д. |итого|дермато- |и т.д. по |итого|физио- |рентгенка-|и |итого| |в |в тыс.|
| | | | | | |консуль-|ческое |по всем | |венероло-|всем кабине-| |терапевти-|бинет |т.п.| | |рублях|рублей|
| | | | | | |тация | |отделениям,| |гический |там, ведущим| |ческий | | | | | | |
| | | | | | | | |ведущим | | |амбулаторный| |кабинет | | | | | | |
| | | | | | | | |амбулатор- | | |прием | | | | | | | | |
| | | | | | | | |ный прием | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
|1|2 |3 |4 |5 |6|7 |8 |9 |10 |11 |12 |13 |14 |15 |16 |17 |18|19 |20 |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Текущие |00|00|00| | | | | | | | | | | | | | | |
| |расходы | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Закупки |10|00|00| | | | | | | | | | | | | | | |
| |товаров и | | | | | | | | | | | | | | | | | | |
| |оплата услуг | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Оплата труда |10|01|00| | | | | | | | | | | | | | | |
| |рабочих и | | | | | | | | | | | | | | | | | | |
| |служащих | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Основной |10|01|01| | | | | | | | | | | | | | | |
| |оклад | | | | | | | | | | | | | | | | | | |
| |гражданских | | | | | | | | | | | | | | | | | | |
| |служащих | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Надбавки к |10|01|02| | | | | | | | | | | | | | | |
| |заработной | | | | | | | | | | | | | | | | | | |
| |плате | | | | | | | | | | | | | | | | | | |
| |гражданских | | | | | | | | | | | | | | | | | | |
| |служащих | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Доплаты к |10|01|03| | | | | | | | | | | | | | | |
| |заработной | | | | | | | | | | | | | | | | | | |
| |плате | | | | | | | | | | | | | | | | | | |
| |гражданским | | | | | | | | | | | | | | | | | | |
| |служащим | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Оплата труда |10|01|04| | | | | | | | | | | | | | | |
| |внештатных | | | | | | | | | | | | | | | | | | |
| |работников | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Прочие |10|01|05| | | | | | | | | | | | | | | |
| |денежные | | | | | | | | | | | | | | | | | | |
| |выплаты | | | | | | | | | | | | | | | | | | |
| |гражданским | | | | | | | | | | | | | | | | | | |
| |служащим | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Начисления на|10|02|00| | | | | | | | | | | | | | | |
| |заработную | | | | | | | | | | | | | | | | | | |
| |плату | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Страховые |10|02|01| | | | | | | | | | | | | | | |
| |взносы в Фонд| | | | | | | | | | | | | | | | | | |
| |социальной | | | | | | | | | | | | | | | | | | |
| |защиты | | | | | | | | | | | | | | | | | | |
| |населения | | | | | | | | | | | | | | | | | | |
| |Министерства | | | | | | | | | | | | | | | | | | |
| |труда и | | | | | | | | | | | | | | | | | | |
| |социальной | | | | | | | | | | | | | | | | | | |
| |защиты | | | | | | | | | | | | | | | | | | |
| |Республики | | | | | | | | | | | | | | | | | | |
| |Беларусь на | | | | | | | | | | | | | | | | | | |
| |государствен-| | | | | | | | | | | | | | | | | | |
| |ное | | | | | | | | | | | | | | | | | | |
| |социальное | | | | | | | | | | | | | | | | | | |
| |страхование | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Страховые |10|02|03| | | | | | | | | | | | | | | |
| |взносы в | | | | | | | | | | | | | | | | | | |
| |фонды | | | | | | | | | | | | | | | | | | |
| |обязательного| | | | | | | | | | | | | | | | | | |
| |медицинского | | | | | | | | | | | | | | | | | | |
| |страхования | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Страховые |10|02|04| | | | | | | | | | | | | | | |
| |взносы по | | | | | | | | | | | | | | | | | | |
| |обязательному| | | | | | | | | | | | | | | | | | |
| |страхованию | | | | | | | | | | | | | | | | | | |
| |от несчастных| | | | | | | | | | | | | | | | | | |
| |случаев на | | | | | | | | | | | | | | | | | | |
| |производ- | | | | | | | | | | | | | | | | | | |
| |стве и | | | | | | | | | | | | | | | | | | |
| |профессио- | | | | | | | | | | | | | | | | | | |
| |нальных | | | | | | | | | | | | | | | | | | |
| |заболеваний | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Приобретение |10|03|00| | | | | | | | | | | | | | | |
| |предметов | | | | | | | | | | | | | | | | | | |
| |снабжения и | | | | | | | | | | | | | | | | | | |
| |расходных | | | | | | | | | | | | | | | | | | |
| |материалов | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Канцелярские |10|03|01| | | | | | | | | | | | | | | |
| |принадлеж- | | | | | | | | | | | | | | | | | | |
| |ности, | | | | | | | | | | | | | | | | | | |
| |материалы и | | | | | | | | | | | | | | | | | | |
| |предметы для | | | | | | | | | | | | | | | | | | |
| |текущих | | | | | | | | | | | | | | | | | | |
| |хозяйственных| | | | | | | | | | | | | | | | | | |
| |целей | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Медикаменты и|10|03|02| | | | | | | | | | | | | | | |
| |перевязочные | | | | | | | | | | | | | | | | | | |
| |средства | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Мягкий |10|03|03| | | | | | | | | | | | | | | |
| |инвентарь и | | | | | | | | | | | | | | | | | | |
| |обмундиро- | | | | | | | | | | | | | | | | | | |
| |вание | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Продукты |10|03|04| | | | | | | | | | | | | | | |
| |питания | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Прочие |10|03|05| | | | | | | | | | | | | | | |
| |расходные | | | | | | | | | | | | | | | | | | |
| |материалы и | | | | | | | | | | | | | | | | | | |
| |предметы | | | | | | | | | | | | | | | | | | |
| |снабжения | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Командировки |10|04|00| | | | | | | | | | | | | | | |
| |и служебные | | | | | | | | | | | | | | | | | | |
| |разъезды | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |командировки |10|04|01| | | | | | | | | | | | | | | |
| |и служебные | | | | | | | | | | | | | | | | | | |
| |разъезды | | | | | | | | | | | | | | | | | | |
| |внутри страны| | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |командировки |10|04|02| | | | | | | | | | | | | | | |
| |и служебные | | | | | | | | | | | | | | | | | | |
| |разъезды за | | | | | | | | | | | | | | | | | | |
| |границу | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Оплата |10|05|00| | | | | | | | | | | | | | | |
| |транспортных | | | | | | | | | | | | | | | | | | |
| |услуг | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Оплата услуг |10|06|00| | | | | | | | | | | | | | | |
| |по связи | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Оплата |10|07|00| | | | | | | | | | | | | | | |
| |коммунальных | | | | | | | | | | | | | | | | | | |
| |услуг | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |оплата |10|07|01| | | | | | | | | | | | | | | |
| |потребления | | | | | | | | | | | | | | | | | | |
| |тепловой | | | | | | | | | | | | | | | | | | |
| |энергии | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |оплата |10|07|02| | | | | | | | | | | | | | | |
| |потребления | | | | | | | | | | | | | | | | | | |
| |газа | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |оплата |10|07|03| | | | | | | | | | | | | | | |
| |потребления | | | | | | | | | | | | | | | | | | |
| |электрической| | | | | | | | | | | | | | | | | | |
| |энергии | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |прочие |10|07|04| | | | | | | | | | | | | | | |
| |коммунальные | | | | | | | | | | | | | | | | | | |
| |услуги | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Прочие |10|10|00| | | | | | | | | | | | | | | |
| |текущие | | | | | | | | | | | | | | | | | | |
| |расходы на | | | | | | | | | | | | | | | | | | |
| |закупки | | | | | | | | | | | | | | | | | | |
| |товаров и | | | | | | | | | | | | | | | | | | |
| |оплату услуг | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |оплата теку- |10|10|02| | | | | | | | | | | | | | | |
| |щего ремонта | | | | | | | | | | | | | | | | | | |
| |оборудования | | | | | | | | | | | | | | | | | | |
| |и инвентаря | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |оплата |10|10|03| | | | | | | | | | | | | | | |
| |текущего | | | | | | | | | | | | | | | | | | |
| |ремонта | | | | | | | | | | | | | | | | | | |
| |зданий и | | | | | | | | | | | | | | | | | | |
| |помещений | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |прочие |10|10|08| | | | | | | | | | | | | | | |
| |текущие | | | | | | | | | | | | | | | | | | |
| |расходы | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Субсидии и |30|00|00| | | | | | | | | | | | | | | |
| |текущие | | | | | | | | | | | | | | | | | | |
| |трансферты | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Трансферты |30|03|00| | | | | | | | | | | | | | | |
| |населению | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |выплаты |30|03|01| | | | | | | | | | | | | | | |
| |пенсий и | | | | | | | | | | | | | | | | | | |
| |пособий | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |прочие |30|03|04| | | | | | | | | | | | | | | |
| |трансферты | | | | | | | | | | | | | | | | | | |
| |населению | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |затраты на | | | | | | | | | | | | | | | | | | |
| |бесплатный | | | | | | | | | | | | | | | | | | |
| |или на | | | | | | | | | | | | | | | | | | |
| |льготных | | | | | | | | | | | | | | | | | | |
| |условиях | | | | | | | | | | | | | | | | | | |
| |отпуск | | | | | | | | | | | | | | | | | | |
| |лекарственных| | | | | | | | | | | | | | | | | | |
| |средств | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Капитальные | | | | | | | | | | | | | | | | | | |
| |расходы | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Капитальные |40|00|00| | | | | | | | | | | | | | | |
| |вложения в | | | | | | | | | | | | | | | | | | |
| |основные | | | | | | | | | | | | | | | | | | |
| |фонды | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Приобретение |40|01|00| | | | | | | | | | | | | | | |
| |оборудования | | | | | | | | | | | | | | | | | | |
| |и предметов | | | | | | | | | | | | | | | | | | |
| |длительного | | | | | | | | | | | | | | | | | | |
| |пользования | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Приобретение |40|01|02| | | | | | | | | | | | | | | |
| |оборудования | | | | | | | | | | | | | | | | | | |
| |и предметов | | | | | | | | | | | | | | | | | | |
| |длительного | | | | | | | | | | | | | | | | | | |
| |пользования | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Капитальный |40|03|00| | | | | | | | | | | | | | | |
| |ремонт | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |в том числе: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |капитальный |40|03|03| | | | | | | | | | | | | | | |
| |ремонт | | | | | | | | | | | | | | | | | | |
| |объектов | | | | | | | | | | | | | | | | | | |
| |социально- | | | | | | | | | | | | | | | | | | |
| |культурного и| | | | | | | | | | | | | | | | | | |
| |бытового | | | | | | | | | | | | | | | | | | |
| |назначения | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Всего затрат | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Сумма в | | | | | | | | | | | | | | | | | | |
| |рублях | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Средний | | | | | | | | | | | | | | | | | | |
| |расход на: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |одно | | | | | | | | | | | | | | | | | | |
| |посещение к | | | | | | | | | | | | | | | | | | |
| |врачу | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |одно | | | | | | | | | | | | | | | | | | |
| |исследование,| | | | | | | | | | | | | | | | | | |
| |манипуляцию, | | | | | | | | | | | | | | | | | | |
| |процедуру, | | | | | | | | | | | | | | | | | | |
| |снимок и т.п.| | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |один километр| | | | | | | | | | | | | | | | | | |
| |пробега | | | | | | | | | | | | | | | | | | |
| |автомобилей | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |один | | | | | | | | | | | | | | | | | | |
| |килограмм | | | | | | | | | | | | | | | | | | |
| |постиранного | | | | | | | | | | | | | | | | | | |
| |мягкого | | | | | | | | | | | | | | | | | | |
| |инвентаря | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |и т.д. | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Сумма в тыс. | | | | | | | | | | | | | | | | | | |
| |рублей | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |Средний | | | | | | | | | | | | | | | | | | |
| |расход на: | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |одно | | | | | | | | | | | | | | | | | | |
| |посещение к | | | | | | | | | | | | | | | | | | |
| |врачу (с | | | | | | | | | | | | | | | | | | |
| |учетом затрат| | | | | | | | | | | | | | | | | | |
| |на бесплатный| | | | | | | | | | | | | | | | | | |
| |или на | | | | | | | | | | | | | | | | | | |
| |льготных | | | | | | | | | | | | | | | | | | |
| |условиях | | | | | | | | | | | | | | | | | | |
| |отпуск | | | | | | | | | | | | | | | | | | |
| |лекарственных| | | | | | | | | | | | | | | | | | |
| |средств) | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |одно | | | | | | | | | | | | | | | | | | |
| |посещение к | | | | | | | | | | | | | | | | | | |
| |врачу (без | | | | | | | | | | | | | | | | | | |
| |учета затрат | | | | | | | | | | | | | | | | | | |
| |на бесплатный| | | | | | | | | | | | | | | | | | |
| |или на | | | | | | | | | | | | | | | | | | |
| |льготных | | | | | | | | | | | | | | | | | | |
| |условиях | | | | | | | | | | | | | | | | | | |
| |отпуск | | | | | | | | | | | | | | | | | | |
| |лекарственных| | | | | | | | | | | | | | | | | | |
| |средств) | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |одно | | | | | | | | | | | | | | | | | | |
| |исследование,| | | | | | | | | | | | | | | | | | |
| |манипуляцию, | | | | | | | | | | | | | | | | | | |
| |процедуру, | | | | | | | | | | | | | | | | | | |
| |снимок и т.п.| | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |один километр| | | | | | | | | | | | | | | | | | |
| |пробега | | | | | | | | | | | | | | | | | | |
| |автомобилей | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |один | | | | | | | | | | | | | | | | | | |
| |килограмм | | | | | | | | | | | | | | | | | | |
| |постиранного | | | | | | | | | | | | | | | | | | |
| |мягкого | | | | | | | | | | | | | | | | | | |
| |инвентаря | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
| |и т.д. | | | | | | | | | | | | | | | | | | |
------------------------------------------------------------------------------------------------------------------------------------------------
Начальник планово-экономического отдела
(экономист) _________ _____________
(подпись) (И.О.Фамилия)
|