Covid - 19 Vaccination Survey
Rajaram College, Kolhapur
Email *
Name of the Student / विद्यार्थ्याचे नाव *
Mobile Number / मोबाईल नंबर *
Course / विभाग *
Year / वर्ष *
Age / वय *
Date of the First Dose / प्रथम डोस दिनांक
MM
/
DD
/
YYYY
Name of the Vaccine / लसीचे नाव
Date of the Second Dose / द्वितीय डोस दिनांक
MM
/
DD
/
YYYY
Name of the Vaccine / लसीचे नाव
Submit
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