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新竹國泰醫院 OEUK體檢預約表單
◼︎預約前請先詳閱檢查流程及注意事項！
◼︎請務必先
「來電」
預約日期，若無電話預約者
「填單無效」
！ Please be sure to make a
“phone call”
appointment in advance. If there is no phone reservation, the
“form submission will be invalid”
!
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* Indicates required question
是否已完成「電話」預約 Have you completed the ‘phone’ reservation
*
是 Yes
否 No
預約體檢日期 Date of examination
*
MM
/
DD
/
YYYY
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