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Prenotazione Vaccinazione di Massa
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Cognome
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Your answer
Nome
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nato/a a
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il
*
MM
/
DD
/
YYYY
TIPOLOGIA
*
RESIDENTE STABILMENTE A RACCUJA
DOMICILIATO STABILMENTE A RACCUJA
LAVORATORE STABILE O STAGIONALE A RACCUJA
Indirizzo di residenza
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Cellulare
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Codice Fiscale
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NUMERO TESSERA SANITARA
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