ผู้ป่วยที่แยกตัวที่บ้าน - ชาวต่างชาติ

Report for Covid-19 patient

Sex *
Type *
Residential style *
Sign and symptoms (Today) *
Are you pregnant? *
Type of Covid-test *
Type of swab *
Have you ever been vaccinated against COVID-19? *
Do you have evidence of vaccination? *
*** Please read carefully*** History during 14 days before illness *

Consent Form for Home Isolation

I am... *
State why the patient is not able to give consent personally (or to sign this form) *
Do you have pulse oximeter and temperature monitor at home? *