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113年健康體位活動-報名表單
請務必填寫正確以利報名及活動抽獎喔
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姓名
*
Your answer
出生年月日(西元)
*
MM
/
DD
/
YYYY
聯絡電話
*
Your answer
居住鄉鎮
*
Choose
台東市
卑南鄉
鹿野鄉
延平鄉
海端鄉
關山鎮
池上鄉
東河鄉
成功鎮
長濱鄉
金峰鄉
太麻里鄉
大武鄉
達仁鄉
蘭嶼鄉
綠島鄉
身高(cm
)
*
Your answer
初始體重(kg)
*
Your answer
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