COVID Vaccine
If you are interested in procuring the COVID vaccine, please fill in the following details and our team will be in touch with you with more details.
Please note that this is just an interest form to help us build adequate supply chain capabilities at our end and is in no way a guarantee on delivery of the vaccine. This is subject to any govt guidelines or conditions
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Email address
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Your email
Name
*
Your answer
E-Mail
Your answer
Phone
*
Your answer
Number of Vaccines Required
*
Your answer
Number of Family Members and their age
Your answer
Is there any chronic disease in the family (like diabetes, heart disease, etc)? If any please give details.
Your answer
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