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COVID-19 REPORTING – Babil Pharmacy
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COVID-19 REPORTING – Babil Pharmacy
COVID-19 REPORTING – Babil Pharmacy
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Full Name
*
Emirates ID Number
*
Email
*
Healthcare professional (Yes/No)
*
YES
NO
Provide Healthcare professional license Number
*
Vaccinated
*
YES
NO
Vaccine Dose
*
First Dose
Second Dose
Third Dose
Third dose date
*
Previous PCR date
*
Most recent PCR date
*
PCR Result
*
Negative
Positive
Upload "Alhosn" or "SMS" screenshoot
*
Click or drag a file to this area to upload.
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