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Hong Kong Shia Asna-I-Ashri Association
Vaccination report form
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* Indicates required question
Date / تاریخ
*
MM
/
DD
/
YYYY
Member’s Name / ممبر کا نام
*
Your answer
WhatsApp Contact Number / واٹس ایپ نمبر
*
Your answer
What is your vaccination status? / آپ کا ویکسینیشن اسٹیٹس کیا ہے؟
*
2nd dose received (fully vaccinated)
Date of vaccination / ویکسینیشن کی تاریخ
*
MM
/
DD
/
YYYY
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