PICK BOOKING VACCINATION FOR PPV KLINIK SP CARE

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a. Adult vaccinee aged 18 and above (based on birth date) that are newly registered
and have not received appointment
b. Adult vaccinee aged 18 and above (based on birth date) that missed 1st or 2nd dose
appointment, or
c. Other groups announced by MOH or state health departments.
d. Vaccine type - Pfizer

Name *

IC No/Passport *

Age *

Gender *

Female

Male

Contact Number *

Severe Allergies Present

Medical History

Healthcare Facility *

KLINIK SP CARE RAWANG MUTIARA (23-10010085)

KLINIK SP CARE BANDAR BARU SELAYANG (23-10010166)

KLINIK SP CARE KOTA DAMANSARA (23-10051686)

KLINIK SP CARE ANTARA GAPI (23-10092238)

Option 6

DOSE *

1st Dose

2nd Dose Defaulted

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