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【調查第3劑施打情形】桃園市補習班、課照中心教職員工第3劑疫苗施打情形調查
1.請於111.1.31中午前填寫。
2.如有最新數據,請隨時登入填寫。
3.已施打第3劑人數包括已預約或預計預約人數。
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機構性質
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補習班
兒童課後照顧服務中心
機構名稱(請填寫立案全名,短期補習班/兒童課後照顧服務中心)
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Your answer
教職員工數(人數)(請填阿拉伯數字)
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Your answer
已施打第3劑人數(含已預約或預計預約)(人數)(請填阿拉伯數字)
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Your answer
教職員工已經或預計將全數完成第3劑施打
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是
否
聯絡人姓名
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Your answer
聯絡人電話
*
Your answer
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