Add New Elderly Add New Elderly 姓名(中) *姓名(英) *性別 *男女年齡 *出生日期 *國籍 *出生地點 *身份證號碼 *緊急聯絡人 *緊急聯絡電話 *上載全身照片(jpg/png)Choose FileNo file chosenDelete uploaded file上載正面照片(jpg/png)Choose FileNo file chosenDelete uploaded file身高體重身材肥胖/略胖/中等/偏瘦/瘦削/其他膚色白/黃/偏黑/黑黝/其他色斑痣臉型方臉/圓臉/長臉/其他頭髮顏色銀白/灰白/啡褐色/黑色/其他髮型光頭/直髮/曲髮/長髮/短髮/未過耳/過耳但未及肩/及肩/地中海（中央頭髮嚴重脫落）/其他其他特徵活動能力行動自如需要使用助行器助行器傘/拐杖/拐杖（兩枝）/三或四腳叉/助行架/有轆助行架/其他能操方言廣東話/國語/潮州話/福建話/客家話/英語/法文/西班牙文/其他語言能力流利/緩慢/含糊/詞不達意/答非所問/其他病歷，記憶及精神狀況沒有/認知障礙症/高血壓/心臟病/糖尿病/癲癇症/腎病/柏金遜症/胸肺疾病/其他視力正常弱視嚴重弱視聽力正常弱聽嚴重弱聽記憶及精神狀況沒有記憶／精神狀況缺損有記憶缺損有精神症狀精神症狀幻覺幻聽妄想混亂抑鬱亢奮沒有現時住址相熟／常掛念的親友該親友住址宗教信仰常到會址過往宗教信仰過往常到會址最喜歡到的地方請輸入長者最喜歡到的食肆登記長者記錄{{#message}}{{{message}}}{{/message}}{{^message}}Your submission failed. The server responded with {{status_text}} (code {{status_code}}). Please contact the developer of this form processor to improve this message. Learn More{{/message}}{{#message}}{{{message}}}{{/message}}{{^message}}It appears your submission was successful. Even though the server responded OK, it is possible the submission was not processed. Please contact the developer of this form processor to improve this message. Learn More{{/message}}Submitting…
