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Registration - Boosting TB Notification (BTN) Campaign
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Email
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Your email
Please write your Full Name
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Your answer
Mention name of your District & State.
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Your answer
Share your official email id
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Your answer
Official Postal Address
*
Your answer
PIN code
*
Your answer
Please share your Gmail id (Required for meeting invitations).
Your answer
Mobile (Whatsapp) Number.
*
Your answer
Date of Birth (DD/MM/YYYY)
*
Your answer
Gender
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Male
Female
Other:
Qualifications with specialization
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Your answer
Preferred language
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English
Hindi
Other:
How do you usually connect to an online meeting ?
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Laptop/Desktop computer
Tablet
Mobile Phone
Source of Internet
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Mobile data
Broadband Connection
Mobile wifi device
Have you used Zoom Video Conferencing tool before?
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Yes
No
Are you comfortable using google drive, google docs, or google sheets?
Yes
No
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Overall, how long have you been posted as a DTO ?
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<1 year
1-3 years
3-7 years
> 7years
Achievements in your relevant field
Your answer
What are three major hurdles you are facing in your district in improving TB care?
Your answer
Please share your main contact persons' information. such as District Program Coordinator (DPC) Name, mobile number & email ID.
Your answer
Comments and suggestions?
Your answer
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