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线上填表小程序,支持微信多人在线填表,excel填表,制作在线登记表(内附请取卵患者扫码填写相关信息模板,仅供参考)

  • 2026-04-22 01:47:55
线上填表小程序,支持微信多人在线填表,excel填表,制作在线登记表(内附请取卵患者扫码填写相关信息模板,仅供参考)
1. 姓名
2. 您的年龄是？
3. 就诊号
4. 是否麻醉

5. 您的身高是多少厘米(cm)？
6. 您的体重是多少公斤(kg)？
7. 您的受教育程度？

8. 您是否患有高血压、糖尿病或冠心病？

9. 您是否吸烟？（若选择是，请填写每日吸烟的数量及吸烟年数）

10. 您是否饮茶或咖啡
  • 经常
  • 偶尔
  • 从不

饮茶

饮咖啡

11. 您是否有手术史？（如有请填写）

12. 您是否饮酒？（若选择是，请填写每日饮酒的数量及饮酒年数）

13. 您的睡眠质量如何？

14. 我感到比往常更加神经过敏和焦虑

15. 我无缘无故感到害怕

16. 我容易心烦意乱或感到恐慌

17. 我感到我的身体好像分成几块，支离破碎

18. 我感到事事都很顺利，不会有倒霉的事情发生

19. 我的四肢抖动和震颤

20. 我的感到无力且容易疲劳

21. 我感到很平静，能安静坐下来

22. 我的感到我的心跳很快

23. 我因阵阵的眩晕而不舒服

24. 我有阵阵要昏倒的感觉

25. 我呼吸时吸气和呼气都不费力

26. 我的手指和脚趾感到麻木和刺痛

27. 我因胃痛和消化不良而苦恼

28. 我必须时常排尿

29. 我的手总是很温暖而干燥

30. 我觉得脸发烧发红

31. 我容易入睡，晚上休息很好

32. 我做噩梦

点击这里进入创建登记表
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  139. /yingpanguazai/ssd/ssd1/www/h.sjds.net/runtime/temp/ad153693ed39fba6d1bda2fe72512cde.php ( 12.06 KB )
  140. /yingpanguazai/ssd/ssd1/www/h.sjds.net/vendor/topthink/think-trace/src/Html.php ( 4.42 KB )
  1. CONNECT:[ UseTime:0.001062s ] mysql:host=127.0.0.1;port=3306;dbname=h_sjds;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.001650s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000734s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000703s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.001381s ]
  6. SELECT * FROM `set` [ RunTime:0.000681s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.001596s ]
  8. SELECT * FROM `article` WHERE `id` = 485993 LIMIT 1 [ RunTime:0.001509s ]
  9. UPDATE `article` SET `lasttime` = 1777048428 WHERE `id` = 485993 [ RunTime:0.001712s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 65 LIMIT 1 [ RunTime:0.000678s ]
  11. SELECT * FROM `article` WHERE `id` < 485993 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.001094s ]
  12. SELECT * FROM `article` WHERE `id` > 485993 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.001175s ]
  13. SELECT * FROM `article` WHERE `id` < 485993 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.002169s ]
  14. SELECT * FROM `article` WHERE `id` < 485993 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.003136s ]
  15. SELECT * FROM `article` WHERE `id` < 485993 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.001885s ]
0.187361s