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Online Enrolment Form

Please complete this registration form in English and in block letters
Personal Details of Expectant Mother
Surname Given Names
ID Card No. / Passport No.
Cantonese Putonghua English Others
DD MM YYYY
Natural Birth Caesarean Section
DD MM YYYY
Personal Details of Expectant Father / Guardian
Surname Given Names
ID Card No. / Passport No.
Cantonese Putonghua English Others
DD MM YYYY
Consultant Obstetrician / Gynecologist
The attending doctor who is responsible for the delivery of your baby.
The attending doctor who is responsible for the collection of your baby's cord blood.
Details of Hospital
>> Go to next page for Medical Health History Form