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Adult Vaccination Registration
Please fill in the details below to book your flu shots or other vaccines with Tata 1mg or to know more about the latest adult vaccinations. Our healthcare concierge shall connect with you.
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Your Name:
*
Your answer
Age
*
Your answer
Gender
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Choose
Male
Female
Contact Number:
*
Your answer
Email id:
Your answer
City:
*
Your answer
Address:
Your answer
Employee ID(only for Tata1mg employees)
Your answer
I would like to know more about:
*
Vaccine for Seasonal Flu
Vaccine for Shingles
Vaccine for HPV / Cervical Cancer Prevention
Vaccine for Pneumococcal
Adult Vaccination Counselling for Multiple Vaccines
Other:
Required
Source Information
*
Tata1mg Retail Store
Corporate tie-up
Emails
Other:
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