疫情信息登记表

Q1:你的姓名（eg. Sofia Zhou）Your name （eg. Sofia Zhou）

Q2:手机号Mobile phone number

Q3:身份证号码ID Number

Q4:家庭住址Home address

Q5:是否接到疾控中心的流调电话Did you receive an epidemiological survey call from Shanghai Municipal Center for Disease Control Prevention?

Q6:是否曾到过中高风险地区？如有，请填写具体地址。Have you ever been to medium-risk regions or high-risk regions？If yes，please fill in details.

Q7:请填写今日在远洋商业大厦的行动轨迹。（例如：18/F、长江会议室、厕所、星巴克等）Please fill in your movement track in the building today. (Such as 18/F, Conference Room Changjiang, Toilet , Starbucks, etc)