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114年度健康檢查活動報名表114 Annual Health Examination Registration Form

今年持續開放服務工眷屬、駐廠清潔、團膳、警衛、派遣、工讀生可自費報名參加有意願參加者,請洽護

_姵佳#128即日起至6/7截止,逾期不候!!

(1) 健檢時間:114/9/10~9/12上午7:30~11:30,共計3天。

(2)   受檢資格:114/3/31()在職員工。(不用報名)

(3)   健檢費用:1500/。(員工免費)

(4)   健檢地點:一樓大廳門口、大廳、會議室區域。

(5)   健檢內容:共計30大項93細項(如附件)

(6)   報名方式:其他人員,請點選連結或掃描QR Code報名。

https://docs.google.com/forms/d/1SFWmKiwRggyudugwB79SSUUIap3e5Fy7Z4cq0yLKFPA/edit

This year, we will continue to open services for family members of employees, factory cleaning, group meals, security guards, dispatchers, and work-study students who can sign up at their own expense.
If you are willing to participate, please contact the nurse_姵佳#128, from now until 6/7, no waiting will be done if you are late!!
(1) Health examination time: 114/9/10~9/112 7:30~11:30 am, a total of 3 days.
(2) Qualification for inspection: 114/3/31 (inclusive), current employees. (No registration required)
(3) Health examination fee: $1,500 /person.
(4) Health examination location: lobby entrance, lobby, conference room area on the first floor.
(5) Health examination content: a total of 30 major items and 93 detailed items. (as attached)
(6) Registration method: For other people, please click on the link or scan and fill in the registration form.

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員工姓名Employee name *
員工工號Employee Job number 
*
單位Unit
*
預約檢查日期Appointment date for inspection *
第一位授檢人_姓名First inspector_name
第一位授檢人_身分證號The first inspector_ID card number
第一位授檢人_出生月日(西元年)The first examiner_birth month and day (Xiyuan year)
MM
/
DD
/
YYYY
第一位授檢人_聯絡電話First inspector_contact number
第一位授檢人_餐點Meal for the first examiner
Clear selection
第二位授檢人_姓名Second inspector_name
第二位授檢人_身分證號The second inspector_ID card number
第二位授檢人_出生月日(西元年)The second examiner_birth month and day (Xiyuan year)
MM
/
DD
/
YYYY
第二位授檢人_聯絡電話Second inspector_contact number
第二位授檢人_餐點Meals for the second inspector
Clear selection
第三位授檢人_姓名The third inspector_name
第三位授檢人_身分證號The third inspector_ID card number
第三位授檢人_出生月日(西元年)The third examiner_birth month and day (Xiyuan year)
MM
/
DD
/
YYYY
第三位授檢人_聯絡電話The third inspector_contact number
第三位授檢人_餐點Meals for the third examiner
Clear selection
第四位授檢人_姓名The fourth inspector_name
第四位授檢人_身分證號The fourth inspector_ID card number
第四位授檢人_出生月日(西元年)The fourth examiner_birth month and day (Xiyuan year)
MM
/
DD
/
YYYY
第四位授檢人_聯絡電話The fourth inspector_contact number
第四位授檢人_餐點Meal for the fourth examiner
Clear selection
第五位授檢人_姓名The fifth inspector_name
第五位授檢人_身分證號The fifth inspector_ID card number
第五位授檢人_出生月日(西元年)The fifth examiner_birth month and day (Xiyuan year)
第五位授檢人_聯絡電話The fifth inspector_contact number
第五位授檢人_餐點Meal for the fifth inspector
Clear selection
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