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Fight Against Drug-Resistant Bacteri Together with CreatiPhage

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    • Subject information collection

    • Personal information
      Name*
      Age*
      Gender*
      Please select
      Male Female
      Place of residence*
    • Diagnostic information
      Current treatment hospital
      Are you currently in the ICU*
      Please select
      Yes No
      Whether breathing equipment is needed*
      Please select
      Yes No
      Whether the hospital can be transferred(Need to confirm with the doctor in charge)*
      Please select
      Yes No
    • Diagnostic information
      Site of infection*
      Please select
      Duration of infection*
      Please select
      Species of infected bacteria*
      Summary of the latest illness
      Upload
      Past medical history
      Upload
      Infecting bacteria type and drug sensitive information
      Please select the type of bacteria
      Please select drug sensitive information
      Add a line
      Please select the type of bacteria
      Please select drug sensitive information
      Please select drug sensitive information
      Please select drug sensitive information
      Please select drug sensitive information
      Please select drug sensitive information
    • Upload data
      Drug sensitive information sheet
      Other data
    • Contact information
      Phone*
      E-mail*
      Contact person*
      Relationship*
    Confirm

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    Tel: 0086-400-668-7738

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