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COVID-19 VACCINATION REGISTRATION
Place - Centenary Hospital, Date - 4th or 5th October
* Indicates required question
Email
*
Your email
NAME
*
Your answer
Subject / Course
*
B.A. (Hons)
B.Com (Hons)
B.Sc. (Hons)
B.A. (Gen)
B.Com (Gen)
B.Sc (Gen)
Current Semester
*
Semester 1
Semester 3
Semester 5
Gender
*
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
MOBILE NO
*
Your answer
ID Number (AADHAR CARD NO)
*
Your answer
Did you taken 1st dose of Covid-19 Vaccination?
*
Yes
No
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