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Campagna antinfluenzale per Donatori AVIS
Compila il seguente format per aderire alla campagna antinfluenzale ed ottenere la vaccinazione gratuita.
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Email
*
Your email
Cognome
*
Your answer
Nome
*
Your answer
Iscritto alla sezione AVIS di ...
*
Your answer
Data di nascita
*
MM
/
DD
/
YYYY
Età (anni compiuti)
*
18-59
60-70
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