Borneo Medical Centre Kuching
Staff e-Health Declaration Form
Staff ID :
*
Full Name :
*
Do you have any Fever, Myalgia, Diarrhea,
ILI, & Other Viral like illness?
Yes
No
Do you have any Cough, Shortness of Breath
OR loss of smell or taste?
Yes
No
Do you attended an event OR areas associated
with known COVID-19 cluster?
Yes
No
Body Temperature / Suhu Badan:
*
Please get the temperature reading from screening staff
After you press "Submit", please show the result summary to Screening Staff.
