JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
每日體溫及健康狀況紀錄表
為監測疫情並及早提供您諮詢, 請回報您的狀況讓我們能進行後續協助。
Sign in to Google
to save your progress.
Learn more
* Indicates required question
日期
*
MM
/
DD
/
YYYY
發 燒(耳溫≥38℃)(額溫≥37.5℃)
*
無
有
是否有咳嗽、呼吸道症狀或其他不適
*
是
否
是否已進行採檢
*
是
否
Submit
Clear form
This form was created inside of 修平科技大學.
Report Abuse
Forms
