Деловое свидание, встреча >Университетская больница Чосон

Деловое свидание, встреча

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CUH Medical Record No.

Name

Gender

Date of birth

Alien Registration No.(If applicable)

Passport No.

Passport/Registration Expiration Date

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Language

Contact No. (In Korea)

Phone Number

E-mail:

Emergency Contact

Contact Name & Relationship to Patient

Phone

Address in Korea

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