学校传染病疫情记录表 | ||||||||||||
土桥初级中学???? 年级??? 班 | ||||||||||||
序号 | 姓?名 | 性别 | 年龄 | 家庭住址 | 发病日期 | 症????? 状 | 采取措施 | 诊断病名 | 诊断单位 | 就诊情况 | 请假情况 | 备注 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
注：“症状”栏，如有发热，则写明发热体温多少℃。 | ||||||||||||
???????? 填表人：?????????? ???????????????????????????????????????????????????????填表日期：????? 年???? 月????? 日?? | ||||||||||||
本文来源：https://www.2haoxitong.net/k/doc/4f20308d9cc3d5bbfd0a79563c1ec5da50e2d620.html
文档为doc格式