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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)時健康狀況:

Health Status of Child When Joining Family:

 

 

醫(yī)療康復與撫育計劃施行情況:

Rehabilitation and Nurture Process:

 

 

 

 

目前生長發(fā)育情況:

Recent Developmental Status:

 

 

 

 

組織名稱:                                   填表日期 :

 

Name of organization:                   Filling date:

 

(China-ccaa.org October 16, 2006)

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