中華基督教會上水堂、主蔭堂、基新堂「接種疫苗」紀錄
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中文姓名 *
聯絡電話 *
所屬堂會 *
是否已接種疫苗?(可剔選多項) *
Required
所接種的劑量 (可剔選多項) *
Required
疫苗名稱(可剔選多項)
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