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Feed-back Information of Special Needs Child

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特殊需要兒童情況反饋表
FEED-BACK INFORMATION OF SPECIAL NEED CHILD

兒童姓名：(原中文名)

Child's Chinese Name

性別：

Sex

生日：

DOB

收養(yǎng)時(shí)健康狀況：

Health Status of Child When Joining Family:

醫(yī)療康復(fù)與撫育計(jì)劃施行情況：

Rehabilitation and Nurture Process:

目前生長(zhǎng)發(fā)育情況:

Recent Developmental Status:

組織名稱(chēng): 填表日期 :

Name of organization: Filling date:

(China-ccaa.org October 16, 2006)

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