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Full Name
No. Handphone
Berapa suhu tubuh Anda ketika mulai bekerja hari ini?
(
What was your body temperature when you started work today?
?)
Temperature < 37,5 (Normal)
Temperature > 37,5 (Not Normal)
Apakah anda mengalami setidaknya salah satu dari gejala berikut?
Are you experiencing at least one of these symptoms?
Ya (Yes)
Tidak (No)
Apakah dalam 3 hari terakhir anda melakukan perjalanan luar kota / luar negeri?
(
In the last 3 days, have you traveled outside the city / abroad?
Ya (Yes)
Tidak (No)
Apakah anda mengalami gejala lain yang belum disebutkan?
(
Are you currently experiencing any other symptoms not yet mentioned above?
)
Yes
No
Proses Data
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