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Vaccination Registration Form
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Email
*
Record my email address with my response
District
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Neelum
Muzaffarabad
Jehlum Valley
Bagh
Haveli
Poonch
Sudhnoti
Kotli
Mirpur
Bhimber
Tehsil
*
Choose
Muzaffarabad
Patika (Naseerabad)
Hattian Bala
Chikar
Leepa
Athmuqam
Sharda
Bagh
Harigehl
Dhirkot
Haveli
Khurshidabad
Mumtazabad
Pallandri
Mong
Trarkhal
Baloch
Rawalakot
Thorar
Hajira
Abbaspur
Mirpur
Dadyal
Bhimber
Smahni
Barnala
Kotli
Sehnsa
Fatehpur
Charhoi
Duliah Jattan
Khuiratta
Union Council
*
Your answer
Village
*
Your answer
Name of Vaccinator
*
Your answer
Vaccinator's Mobile No.
*
Your answer
Premises Type
*
Choose
House
Dairy Farm
Sheep/Goat Farm
Other
Farmer Name
*
Your answer
Farmer's Mobile No.
*
Your answer
Date of Vaccination
MM
/
DD
/
YYYY
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