JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Student profile for COVID19 early preparedness response-Faculty of Arts
கலைப்பீட 3ம் வருடம் 2ம் அரையாண்டு 4ம் வருடம் 1ம் அரையாண்டு மாணவர்களுக்கானது.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
1. Full name
*
Your answer
2. Name with initials
*
Your answer
3. Registration number(Eg. 2014/A/001)
*
Your answer
4. Permanent address
*
Your answer
5. Present address (If it is not same as above)
Your answer
6. Contact number
*
Your answer
7. Contact email
*
Your answer
8. Contact number of parent/guardian
*
Your answer
9. Present Medical officer of Health (MOH) Area
*
Your answer
10. Present Public health Inspector range
*
Your answer
11. Have you had any exposure history to COVID 19
*
"You" or "Your close contacts"
Yes
No
Other:
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of University of Jaffna.
Report Abuse
Forms
