To Whom Who Receive One Month Checkup

Checkup Date ／

Please finish your registration between 1:00 and 1:30 pm.

For mothers, please check in to Gynecology with Automatic Revisit Registration

Machine.

For babies, please let us know your name at Window ①, and you will receive “One

Month Checkup Kit”, and we will explain what to do next.

☆ Things to bring☆

Insurance Certificate, Infant Medical Certificate, Patient Registration Cards (both

for mothers and babies), Maternity Record Book, One Month Checkup

Questionnaire

Cost（Mother 1380yen・baby 800yen, If you are coming from out of the

prefecture, it will cost about 5000yen. (If you submit to your residential Ward

Office/City Hall, it will be reimbursed.）

For babies…2 to 3 diapers, wet wipes, changing clothes, the bottle set if you are

bottle feeding (hot water, too)

☆ To fill out before you came☆

Infant One Month Checkup Questionnaire

“The First Infant General Health Checkup List” in the Maternity Record Book

☆ Attention☆

・ Please let our staffs know if you are feeding your babies during the checkup.

・ If you wish to change the date of the checkup, please call to Pediatric

Outpatient first from 3:00 to 5:00 pm in weekdays, and inform to Gynecology

Outpatient after you changed the appointment. However you cannot

change the checkup date earlier than the original appointment.

・ Please call to Gynecology Outpatient if you have to cancel the appointment

on that day.