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健康聲明調查表
基本資料Basic information
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捷絲旅台北三重館 Just Sleep Sanchong
地址 : 新北市三重區和路四段107-1號
No.107-1, Sec. 4, Sanhe Rd., Sanchong Dist., New Taipei City,Taiwan(R.O.C.)
TEL : 02-2280-6111
Email :
fo.sc@justsleep.com.tw
Line ID : jsscfo888
What’s app/Wechat ID: JSSCFO
姓名(Name)
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Your answer
電話(TEL)
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Your answer
性別(M/F)
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女 Female
男 Male
身分證字號／護照號碼 ／居留證號碼(ID Number/Passport Number/Residence permit number)
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Your answer
出生年月日 Date of Birth
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MM
/
DD
/
YYYY
請填寫抵達台灣之航班(航空公司) Please fill the form of the airline company's name :
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Your answer
抵台灣航班日期 Arrival date :
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MM
/
DD
/
YYYY
航班時間 Arrival flight time :
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Time
:
AM
PM
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