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Encuesta de caracterización COVID-19
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Tipo de vinculación con Ingedisa
*
Colaborador/a
Proveedor/a
Externo/a
Otro
Nombres y Apellidos
*
Your answer
Correo electrónico
*
Your answer
Sexo
*
Mujer
Hombre
Intersexual
Edad
*
Your answer
Documento de identidad
*
Your answer
Cargo
*
Your answer
Área
*
Your answer
Teléfono de contacto
*
Your answer
Nombre de contacto de emergencia
*
Your answer
Teléfono del contacto de emergencia
*
Your answer
EPS
*
Your answer
ARL
*
Your answer
Ciudad de residencia actual
*
Bogotá
Otro
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