(1) The province, city and district where you are currently located (please provide your current location in detail as far as possible);
(2) Whether there is still 1 case of COVID-19 infection in this county and the residence history in this county within 14 days;
(3) The name of the restricted person;
(4) The ID number (or passport number) of the restricted person;
(5) The mobile phone number registered by the restricted person's real name (preferably the mobile phone number registered by the restricted person's real name and bound to Beijing Health Bao);
(6)/kloc-places you have been or passed within 0/4 days (if you take a train or plane, please provide the name of the origin and destination, boarding time, train number and flight information as proof);
(7) Whether the travel card without * sign is normal;
(8) Specific issues;
(9) Have you had any contact with the destination community (village) before and after coming to Beijing (please fill in yes or no);
(10) Please confirm that the information provided is true and valid (please fill in Yes or No).