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英語 高校生

わからないので教えてください。😭

B With a partner, take turns playing the roles of nurse and patient. Ask each other the questions you need to ask to fill out the application form below. One partner is Robert Jones, the other is Mary Woods. Robert William Jones D.O.B. 9/12/70 23-42 Shiizaki, Sakae-machi, Inba-gun, Chiba-ken, 289-1222 Tel.: 0475-72-1234 Businessman Stomachache Came to this hospital before with back pain in October, 2012 Mary Margaret Woods D.O.B. 7/31/80 7512 22nd Ave. N.W. Portland, Oregon 98115-4706 Tel.: (425) 791-8836 Housewife Sprained ankle First time at this hospital APPLICATION FORM Last Name month Date of Birth Address Telephone Occupation (Circle one) month Date First Name day year day year Middle Name Sex M / F years old Which department would you like to go to? (Circle one) 1 Self-employed 01 Internal Medicine 11 Obstetrics & Gynecology (OB/GYN) 2 Farmer/Skilled worker 02 Pediatrics 12 Ophthalmology (Eye doctor) 3 Civil servant 03 Surgery & Treatments 13 Dermatology (Skin doctor) 4 LO 00 5 6 Businessman Student Housewife 04 Orthopedics 14 Nutrition & Dietetics 05 Neurology 15 Radiology (X-ray) 06 Urology 16 Oral Surgery 7 Unemployed 07 Respiratory Medicine 17 Cardiology 8 Hospital employee 18 Plastic Surgery 08 Psychiatry 9 09 Otolaryngology (ENT) 19 Dentistry Other: (Please specify): 10 Anesthesiology 20 Allergy & Immunology 1. NO Have you ever been to this hospital before? 2. YES (Year: ) (Department: )

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