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["考试人员健康管理信息采集表"]
["姓名","健康排查(流行病学史筛查）"]
[null,"是否有21天内国内中、 高风险等疫情重点地区旅居地 (县(市、 区)",null,"是否有28 天内境外旅居地（国家地区）","居住社区\n21 天内\n发生疫情\n①是\n②否","属于下面哪种情形\n①确诊病例②无症状感染者③密切接触者 ④从14天内有新增本土疫情的省份入聊返聊者⑤以上都不是","是否解除医\n学隔离观察①是②否 ③不属于","核酸检测\n①阳性\n②阴性\n"]
[]
[]
[]
[]
["","",null,"","",null,"",""]
["健康监测(自考前14天起)"]
["天数","监测\n日期","健康码 ①红码 ②黄码 ③绿码","早体温","晚体温","是否有以下症状 ①发热②乏力、 味觉和嗅觉减退③咳嗽或打喷嚏④咽痛⑤腹泻 ⑥ 呕吐⑦黄疸⑧皮疹⑨ 结膜充血⑩都没有","如出现以上所列症状,是否排除疑似传染病 ①是 ②否"]
[1,null,"","","","",""]
["2",null,"","","","",""]
["3",null,"","","","",""]
["4",null,"","","","",""]
["5"]
["6"]
["7"]
["8"]
["9"]
["10"]
["11"]
["12"]
["13"]
["14"]
["考试当天"]
["本人承诺：以上信息属实，如有虚假、瞒报、愿承担责任及后果。                                                                  "]
["签字：                                                                                    联系电话："]