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Covid-19 Vaccination Record
Organized by,
PSSC, NSS, Nutan Mahavidyalaya, Selu
and
SDH, Selu
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* Indicates required question
Email
*
Your answer
Name
*
Your answer
Address
*
Your answer
Age
*
Your answer
Number of the Member in Family
*
Your answer
Whatsapp No
*
Your answer
Have you Taken Vaccine?
Yes
No
Clear selection
If yes, How many doses have you completed?
1
2
Clear selection
Which vaccine have you taken?
Covaxin
Covishield
Clear selection
How many members in the family are vaccinated?
Your answer
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