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The Hospital Bill Promissory Note is commonly used in Hong Kong's healthcare system when patients are unable to pay their medical bills in full at the time of service. This document, governed by Hong Kong law, particularly the Bills of Exchange Ordinance (Cap. 19) and healthcare regulations, provides a legally enforceable solution for hospitals to secure payment while offering patients a structured payment arrangement. The promissory note typically includes the principal amount owed, payment schedule, interest rates, and default provisions. It serves as a crucial tool for healthcare facilities to manage accounts receivable while providing patients with clear documentation of their payment obligations. The document must comply with both healthcare regulations and financial instruments law, making it a specialized form of promissory note specific to medical debt.

1. Date and Place of Execution: Specifies when and where the promissory note is executed

2. Parties: Identifies the maker (patient/debtor) and payee (hospital)

3. Amount: States the principal sum owed in both numbers and words

4. Promise to Pay: Contains the unconditional promise to pay the specified amount

5. Payment Terms: Specifies when and how payment(s) will be made, including installment details if applicable

6. Interest Rate: States any applicable interest rate and how it is calculated

7. Default Provisions: Outlines consequences of failing to make payments as agreed

8. Reference to Hospital Bill: Identifies the specific hospital bill(s) being covered by the note

9. Signature Block: Space for maker's signature and witness attestation