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我想預約帕金森病初診時間
僅限預約
帕金森病初診
(第一次於本診所就醫),提交表單後,由專人聯繫並完成預約。
以下病患個人資料是做為預約掛號建檔。
陸教授神經科診所 (03) 396 0388
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* Indicates required question
病患姓名
*
Your answer
病患性別
*
男
女
病患出生年月(以西元年/月/日為主,例如:2023/12/31)
MM
/
DD
/
YYYY
病患身份證號碼
Your answer
聯絡人姓名
*
Your answer
聯絡手機 (例如 09XX 000 123; 若無手機,請填寫數字"0")
*
Your answer
室內電話 (例如 03-3960388; 若無室內電話,請填寫數字"0")
*
Your answer
可聯絡的時間 (請勾選);原則上是上午及下午為主
*
上午 8:30~12:00
下午 1:30~5:00
晚上 5:30~6:30
Required
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