Register for Vaccination (टीकाकरण के लिए पंजीकरण )
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COVISHIELD VACCINATION AVAILABLE- PRICE Rs. 780/- only. (कोविशील्ड टीकाकरण उपलब्ध। मूल्य मात्र रु. 780/-)
Your Photo ID will be verified at the time of your vaccination appointment. Please provide the details of the Photo Id you will carry for vaccination.
Full Name (आपका पूरा नाम) *
Gender (लिंग) *
Your Present Address (आपका वर्तमान पता) *
Year of Birth (जन्म का साल) *
Photo ID Proof (पहचान प्रमाण पत्र) *
Photo ID Number (पहचान प्रमाण पत्र नंबर) *
Contact Number (संपर्क नंबर) *
Email ID (ई मेल आईडी) *
Which Dose? (कितना नंबर डोज?) *
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