来访者健康调查表

VISITOR HEALTH DECLARATION

: 姓名: VISITOR NAME: 到访日期及时间: DATE OF AND TIME OF VISIT: 所属单位名称: COMPANY NAME: 所属单位地址: COMPANY ADDRESS: 住址: ADDRESS IN CHINA 过去4周内所到之地区: CITY VISITED WITHIN THESE 4 WEEKS: 现有否带病(如「有」请列明): DO YOU HAVE ANY DISEASE SUFFERING? (IF ‘YES’, PLEASE LIST OUT) 特别提示：1. 凡患有开放性或活动性肺部、传染性肝炎、流行性感冒、肠道传染病、化脓性或渗出性皮肤病、疥疮或其它传染病者，不得进入车间。 2. 不得留长指甲和涂指甲油。 3. 进入车间前，要更换工作服、帽、鞋，工作服、帽穿戴整齐，头发不外露。 4. 双手必须清洗消毒，双脚踩过消毒池进入车间。 5. 严禁佩带戒指、颈链、手镯、手链、耳环等各种首饰和手表。 6. 严禁将与生产无关的个人用品如雨伞、食品等带入车间 IMPORTANTNOTES: 1.ANY ONE SUFFERING THE FOLLOWING DISEASE, PLEASE SO NOT ENTER THE PRODUCTION AREA: T.B., CONTAGIOUS HEPATITIS, CONTAGIOUS GASTRIC DISEASE AND ENTERROVIRUS CARRIER, SUPPURATIVE OR EFFUSIONAL SKIN DISEASE, SCABIES, HAND WOUNDED, OR ANY DISEASE WHICH WILL AFFECTED FOODS HYGIENE. 2. NO NA IL POLISHING, NO LONG FINGER NAIL, NO LONG HAIR. 3.WEARING WORKING CLOTH, HAIRNET, SHOES, NEATLY NAD NO HAIR EXPOSE BEFORE ENTERING THE PRODUCTION AREA. 4.WASH STERILIZE YOUR HAND AND, GO THROUGH THE FOOTBATH TO ENTER THE PORDUCTION AREA. 5.NO JEWELRY SUCH AS FINGER RING, NECKLACE, BANGLE, BRACELET, EARRING AND WATCHES ARE NOT ALLOWED TO BE BROUGHT IN TO THE PRODUCTION AREA. 6. ANYTHING NOT REATIGN TO THE WORK SUCH AS UMBRELLA, FOODS ARE STRICTLY PROHIBIT TO BE BROUGHT INTO THE PRODUCTION AREA. 身份证： ID NO.: 离开时间: TIME OF LEAVING:

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