教協內窺鏡中心「結腸鏡、胃鏡檢查」預約登記表
PTU Endoscopy Centre
Colonoscopy or OGD Examination Registration Form
檢查項目 Examination Items: 結腸鏡 Colonoscopy
胃鏡 OGD
結腸鏡及胃鏡 Colonoscopy & OGD
姓名 Name:
會證類別
Type of Membership:
會員證 PTU Member
家屬證 Family Card
非會員 Non-member
會員證/家屬證/身份證號碼
Membership/ I.D. Card No. :
(非會員請填香港身份證首4位數字)
(For non-members, please enter the first 4 digits
of your HK I.D. Card)
聯絡電話 Contact No. :
擬進行檢查日期
Preference of Appointment Date:
1.  上午A.M.
2.  上午A.M.
請輸入驗証碼
Please enter pass-phrase:
pass-phrase  

* 收集個人資料只作是次登記之用
* Personal information received will only
be used for registration.
查詢:
Enquires:
2782-2316 (後按 1 > 4)
2782-2316 (press 2 > 4)