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COVID-19 REPORTING – Ibn Nafees Medical Center, Khalifa City

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COVID-19 REPORTING – Ibn Nafees Medical Center, Khalifa City

COVID-19 REPORTING – Ibn Nafees Medical Center, Khalifa City

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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