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居家隔離造冊
請填寫正確資料!
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Email
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班級(舉例:機一甲，請以同樣格式填寫)
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座號
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姓名
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自有手機號碼
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出生年月日
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DD
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YYYY
接觸者身分別
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同班同學
宿舍室友
接觸地點
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教室
宿舍
身份證字號
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居住地址(平常居住的地方)
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戶籍地址
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隔離地址(居家隔離的地點) *務必填寫正確，以免因未確實居隔而被罰錢!
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