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基隆市立中正國中關於新型冠狀病毒(武漢)肺炎調查問卷(學生版)
以下問卷請詳實填寫
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你/妳的班級?（請填答數字，如：701、702...）
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你/妳的座號?（請填答數字）
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你/妳的姓名
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請問你/妳和家人(無論是否住一起)是否曾經在1-2月間到過中國、香港、澳門等地探親、旅遊(含轉機)或工作?
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