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六家國小【傳染病】狀況通報單(老師填報)
麻煩老師遇到班上有學生有以下傳染疾病確診時填寫本表單,以利學校進行後續資料整合,感謝您的配合
1.腸病毒
2.流感
3.新冠肺炎
4.水痘
5.諾羅病毒
6.登革熱
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學生或教職員工確診姓名
*
Your answer
就醫診所
*
已知就醫診所,請在【其他 】請填就醫診所
未就醫,自行快篩
就醫院所不詳
Other:
學生或教職員工確診或快篩陽性疾病類別
*
腸病毒
流感
新冠肺炎
水痘
諾羅病毒
登革熱
學生或教職員工確診或快篩陽性日期
*
MM
/
DD
/
YYYY
學生或教職員工最後到校日
*
MM
/
DD
/
YYYY
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