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1130504親子教室報名表
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姓名
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您的預產期？
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MM
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DD
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YYYY
請問這是第幾胎？
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第一胎
第二胎
第三胎
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請問您是否在本院產檢？(未在本院產檢請在其他填寫產檢醫院)
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是
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您如何得知親子教室報名資訊？
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醫院官網
醫院Facebook
門診公告、宣傳單
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