疫情上报登记表 - 题目详情
题型:单选填空
1. <span style="color: rgb(56, 56, 56); font-family: "Helvetica Neue", Helvetica, "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; background-color: rgb(255, 255, 255);">上报人姓名</span>
选项: 1、选项1
题型:单选填空
2. <span style="color: rgb(56, 56, 56); font-family: "Helvetica Neue", Helvetica, "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; background-color: rgb(255, 255, 255);">上报人手机号</span>
选项: 1、选项1
题型:单选填空
3. <span style="color: rgb(56, 56, 56); font-family: "Helvetica Neue", Helvetica, "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; background-color: rgb(255, 255, 255);">上报人性别</span>
选项: 1、选项1
题型:单选填空
4. <span style="color: rgb(56, 56, 56); font-family: "Helvetica Neue", Helvetica, "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; background-color: rgb(255, 255, 255);">上报人出生年月</span>
选项: 1、选项1
题型:单选填空
5. <div><br></div><div><span style="color: rgb(56, 56, 56); font-family: "Helvetica Neue", Helvetica, "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif; background-color: rgb(255, 255, 255);">代填人姓名(本人上报无需填写)</span><br></div>
选项: 1、选项1
题型:单选填空
6. <div><br></div><div><span style="color: rgb(56, 56, 56); font-family: "Helvetica Neue", Helvetica, "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif;">代填人手机号(本人上报无需填写)</span><br></div>
选项: 1、选项1
题型:多选题
7. <span style="color: rgb(56, 56, 56); font-family: "Helvetica Neue", Helvetica, "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif;">上报人是否存在以下症状?</span>
选项: 1、发热, 2、干咳, 3、乏力, 4、咳痰, 5、鼻塞, 6、流涕, 7、呼吸困难, 8、头疼, 9、胸闷, 10、呕吐, 11、腹泻, 12、其他症状, 13、以上都没有
题型:多选题
8. <span style="color: rgb(56, 56, 56); font-family: "Helvetica Neue", Helvetica, "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei", Arial, sans-serif;">上报人是否存在疫情地区旅游史/接触史,或相关病患接触史?</span>
选项: 1、是, 2、否
题型:备注说明
9.
选项: 1、选项1
题型:上传文件
10. 请填写以下信息
题型:商品题
11. 请填写以下信息
选项: 1、商品名称


2025-07-08










