AgRDT Reporting Form for General Public
Official Antigen RDT reporting form from Epidemiology and Disease Control Division, Ministry of Health and Population, Nepal
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Email *
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First Name *
Last name *
Age (in years) *
Sex *
Nationality *
District *
Municipality *
Ward No *
Tole *
Occupation *
Contact No. *
Travel History ( Last Visit place in 7 days)
Reason for Test *
Reason for Testing (Optional)
Result *
Date of Testing *
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