What was the time when you are filling the form?（时间）
Your current temperature
Normal正常(37.3℃)
Abnormal体温异常(≥37.3℃) Please specify
Did you or will you leave the company today?
NO没有离开公司
Yes and I haven’t leave.
Yes and I have returned.
Yes and I am on my way.
Your colleagues stay in the company today?
YES在
NO不在 If NO, please specify the situation.
I work alone
Do you or any of your colleagues have the following symptoms？
Fever发热（≥37.3）
Cough咳嗽
Sore throat咽痛
Chest Tightness胸闷
Difficulty in breathing呼吸困难
Mild limbs/lower back muscle soreness/weakness/poor energy轻度四肢/腰背部肌肉酸痛/乏力/精神稍差
Nausea, vomiting/diarrhea恶心呕吐/腹泻
Headache头痛
Tachycardia心慌
Others其他
None of above无以上症状
In the past 14 days, have you or your colleagues been in contact with persons who are back to the company from other cities ？
NO没有
YES有 If yes, please specify the details: person, date and Vehicle (Train No.).
In the past 14 days, have you or your colleagues travelled from medium-risk or high-risk areas to the company?
NO没有
YES有 If yes, please specify the details: person, date and Vehicle(Train No./Flight No./Car No.)
Do you have any visitors from other companies in the same city today?
NO没有
YES有 If yes, please specify the details: person, date and Vehicle(Train No./Flight No./Car No.)
当前所在办公地点（请自行脱敏处理，如用模糊地址等）
I promise I will fill the bellowing form with true and accurate information and bear the correspondent responsibilities if I was covering up.
What's your favorite sport?
Basketball
Football
Running
Swimming