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Vaccination Details of the Students
Please submit this google form carefully on or before 05.11.2021 at 12.00noon
Assistant Registrar,
Faculty of Agriculture
* Indicates required question
Email
*
Your email
Registration Number
*
AG/XXXX/XXXX/XXX OR AG/XXXX/XXX
Your answer
Name with initials
*
Your answer
Intake / Batch
*
2019/2020
2018/2019
2017/2018
2016/2017
Vaccination Status
*
1st & 2nd dose taken
1st dose taken
Not vaccinated
Other:
Name of the Vaccine taken
*
Sinopharm
Moderna
Oxford–AstraZeneca
Sputnik V
Pfizer–BioNTech
Other:
Date of 1st Vaccination
MM
/
DD
/
YYYY
Date of 2nd Vaccination
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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