OPD patients questionnaire
Please answer those questions and show us when you arrive at hospital. Thank you very much for your cooperation.
Do you have Cough / Runny nose/ Stiffy nose / sore throat?
Yes
No
Do you have short of breath / difficulty in breathing ?
Yes
No
Do you have smell/ taste problem?
Yes
No
Have you travelled out of Cambodia within 5 days?
Yes
No
Were you hospitalized in other hospital within 2 weeks?
Yes
No
Have you contacted with COVID patient within 2 weeks?
Yes
No