WELCOME TO TAIWAN HPV WEB 
　
　

Patient's Basic Information:    Male Female ID Number  
Name   Date of Birth  YearMonthDay
Contact Number （） Guardian  
Name of Injection Center  
Company of Product/Medication MSD       GSK
Injection Time

Initial Injection     YearMonthDayHourMinute

Second Injection  YearMonthDayHourMinute

Third Injection       YearMonthDayHourMinute
Medical History Pregnancy： No Yes ， Allergy: No Yes ，  Fever： No Yes 
Recommendation

　

 Pap Smear Test: Those who have been sexually active should have Pap Test regularily

        YearMonthDay

HPV Test：YearMonthDay