COVID Vaccine Booster Dose (Over 60yrs)
This programme is only for those over 60 years of age who had previous two doses from any brand of COVID vaccines. Minimum of 3 months should have elapsed from the date of the second dose.
Please bring your NIC and vaccination card.
Priority will be given for those who come with an appointment.
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Name *
(නම/பெயர்)
Mobile Number *
(ජංගම දූරකථන අංකය/கைபேசி எண்)
NIC *
(ජාතික හැඳුනුම්පත් අංකය/தேசிய அடையாள அட்டை எண்)
Gender *
(ස්ත්‍රී පුරුෂ භාවය/பாலினம்)
Age *
( වයස/வயது)
Which vaccine did you receive previously? *
(ඔබ කලින් ලබා ගත් එන්නත කුමක්ද?/இதற்கு முன்பு நீங்கள் எந்த தடுப்பூசியைப் பெற்றீர்கள்?)
Date of second dose *
(දෙවැනි මාත්‍රාවේ දිනය/இரண்டாவது டோஸ் தேதி)
MM
/
DD
/
YYYY
Appointment Date *
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