衛生福利部屏東醫院預約自費採檢COVID-19(新冠肺炎)登記表
一、請詳閱自費採檢COVID-19說明後,填寫以下表單。
二、填寫提交完成後,本院窗口將與您連繫。
三、諮詢窗口(08)7363011分機2188。
姓名(Name) *
生日 年/月/日 (Date of Birth yyyy/mm/dd) *
性別(Gender) *
身分證字號(ID Card)/居留證號碼(ARC No.) *
電話(Telephone Number) *
住址(Address) *
預約採檢午別 *
領取報告時間及費用 *
預約採檢日期(Appointment date for Covid-19 Testing) *
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