Voluntary application form for Covid-19 first dose vaccine

 

• Why fill out this form?
• 1) To get information on which center you want to vaccinate
• 2) This is a voluntary, individual application form
• 3) This form is requested to be filled by persons 18 years of age and above who have not yet been vaccinated.
• 4) The details obtained from this application form will be used for planning and management related to vaccination at the municipal level
• 5) This form does not indicate the certainty of vaccination immediately

Form Link:click here