Government of Ontario: Ministry of Health

700 - 75 Albert Street
Ottawa ON  K1P 5Y9
613 545–0656

Out of Province In-Patient Standard Ward Costs

 

 












Line No. 1


Patient’s surname (for married Quebec female residents, surname at birth), first name, address




















Line No. 2


Patient’s surname (for married Quebec female residents, surname at birth), first name, address




















Line No. 3


Patient’s surname (for married Quebec female residents, surname at birth), first name, address




















Line No. 4


Patient’s surname (for married Quebec female residents, surname at birth), first name, address




















Totals