Registration for Covid-19 Vaccine from Mor Prachuab Prom, provided by the Provincial Public Health of Prachuab Kirikhan (White List for Foreigners)

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This registration is only for residents, expats and workers who reside or live in Prachub Khirikhan and who have not registered for the vaccine on any platform or channel before. If you have registered before, please do not register again as it may cause a duplication.

Please select your group

Please select your province (current residence) *

77 - Prachub Khirikhan

Please select your type of group

Please select your sub-district of residence

Please select your district of residence

Please put your Moo (in number only. If none, use -) *

Select your preferred vaccination venue

Salutation

Bee

Bahardu

Gender

27 /11 /1969

YYYY

Your email address (The modified number will be sent to your email so please fill correctly) *

Your Thai phone number, if any

Passport Number *

Myanmar

Yes

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