兒科線上實習(xí)同學(xué)資質(zhì)表（20223起）附答案

兒科線上實習(xí)同學(xué)資質(zhì)表（2022.3起）[復(fù)制]各位同學(xué)好，因我院為JCI資質(zhì)醫(yī)院，所有實習(xí)同學(xué)需要填寫以下信息備案。謝謝！

（注：問卷中個人信息作為存檔用，不會對外公開?。?/p>

Helloeveryone,becauseourhospitalisaJCIqualifiedhospitalandthecurrentepidemicpreventionandcontrolrequirements,allinternstudentsneedtofillinthefollowinginformationfortherecord.Studentsareaskedtotakethetimetofillinbeforeenteringthedepartment.Thanks!

(Note:Thepersonalinformationinthequestionnaireisforarchivingpurposesandwillnotbedisclosedtothepublic!)1.學(xué)號（studentID）[填空題]_________________________________2.姓名（Name）[填空題]_________________________________3.性別(Gender)[單選題]○男○女4.聯(lián)系電話(MobilePhone)[填空題]_________________________________5.身份證號(ID)[填空題]_________________________________6.民族(Nationality)[填空題]_________________________________7.畢業(yè)省份(ProvinceofSeniorHighSchool)[填空題]_________________________________8.高中畢業(yè)學(xué)校(HighSchool)[填空題]_________________________________9.考入復(fù)旦大學(xué)的年份(YearenrolledintoFudan)[填空題]_________________________________10.班級(Class)[單選題]○中山班○華山班○華東班○其他(Others)_________________11.專業(yè)(Specialty)[單選題]○臨床醫(yī)學(xué)8年制○臨床醫(yī)學(xué)5年制(非兒科方向)○臨床醫(yī)學(xué)5年制(兒科專業(yè)方向)○藥學(xué)○預(yù)防醫(yī)學(xué)○公共事業(yè)管理○法醫(yī)學(xué)○其他_________________○MBBS○選項1712.上學(xué)期績點GPA（GPAforlastsemester)[填空題]_________________________________13.兒科實習(xí)入科日期（Pediatri