My insurance
School name
Name

(as written in the passport)

Sex
Male female
Alien Registration No.
Yes No
  -  

(If No, enter 6-digit number for date of birth-YYMMDD)

Nationality
E-mail
Student No
Mobile phone No
Messenger (Kakao Talk) ID.
Current health conditions
GOOD BAD
Past history of illness
None Present
Affiliation
Under graduate Korean language Graduate Exchange student Undergraduate & Graduate Etc
Korean National Health Insurance
Yes I have No I don't have